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Showing papers by "Hylton B. Menz published in 2016"


Journal ArticleDOI
TL;DR: Limited evidence supports the effectiveness of transition from rearfoot to forefoot or midfoot strike and increase step rate or altering proximal mechanics in individuals with anterior exertional lower leg pain; and visual and verbal feedback to reduce hip adduction in females with patellofemoral pain.
Abstract: Importance Running-related injuries are highly prevalent. Objective Synthesise published evidence with international expert opinion on the use of running retraining when treating lower limb injuries. Design Mixed methods. Methods A systematic review of clinical and biomechanical findings related to running retraining interventions were synthesised and combined with semistructured interviews with 16 international experts covering clinical reasoning related to the implementation of running retraining. Results Limited evidence supports the effectiveness of transition from rearfoot to forefoot or midfoot strike and increase step rate or altering proximal mechanics in individuals with anterior exertional lower leg pain; and visual and verbal feedback to reduce hip adduction in females with patellofemoral pain. Despite the paucity of clinical evidence, experts recommended running retraining for: iliotibial band syndrome; plantar fasciopathy (fasciitis); Achilles, patellar, proximal hamstring and gluteal tendinopathy; calf pain; and medial tibial stress syndrome. Tailoring approaches to each injury and individual was recommended to optimise outcomes. Substantial evidence exists for the immediate biomechanical effects of running retraining interventions (46 studies), including evaluation of step rate and strike pattern manipulation, strategies to alter proximal kinematics and cues to reduce impact loading variables. Summary and relevance Our synthesis of published evidence related to clinical outcomes and biomechanical effects with expert opinion indicates running retraining warrants consideration in the treatment of lower limb injuries in clinical practice.

128 citations


Journal ArticleDOI
TL;DR: Women wear shoes with a lower heel and broader toe box as they age, and wearing constrictive footwear between the ages of 20 and 39 may be critical for developing hallux valgus in later life.
Abstract: Background: Foot problems are prevalent in older women and are thought to be associated with footwear. This study examined women’s shoe wearing patterns over time and evaluated associations between footwear characteristics and foot pain and hallux valgus.

65 citations


Journal ArticleDOI
TL;DR: The available evidence indicates that although foot pain is common and disabling in older people, conservative interventions such as routine foot care, footwear advice and foot orthoses are effective at reducing foot pain and may also assist in maintaining mobility and independence in this age group.

46 citations


Journal ArticleDOI
TL;DR: To compare the effectiveness of prefabricated foot orthoses to rocker‐sole footwear in reducing foot pain in people with first metatarsophalangeal (MTP) joint osteoarthritis (OA) is compared.
Abstract: Objective To compare the effectiveness of prefabricated foot orthoses to rocker-sole footwear in reducing foot pain in people with first metatarsophalangeal (MTP) joint osteoarthritis (OA). Methods Participants (n = 102) with first MTP joint OA were randomly allocated to receive individualized, prefabricated foot orthoses or rocker-sole footwear. The primary outcome measure was the pain subscale on the Foot Health Status Questionnaire (FHSQ) at 12 weeks. Secondary outcome measures included the function, footwear, and general foot health subscales of the FHSQ; the Foot Function Index; severity of pain and stiffness at the first MTP joint; perception of global improvement; general health status; use of rescue medication and co-interventions to relieve pain; physical activity; and the frequency of self-reported adverse events. Results The FHSQ pain subscale scores improved in both groups, but no statistically significant difference between the groups was observed (adjusted mean difference 2.05 points, 95% confidence interval [95% CI] −3.61, 7.71; P = 0.477). However, the footwear group exhibited lower adherence (mean ± SD total hours worn 287 ± 193 versus 448 ± 234; P < 0.001), were less likely to report global improvement in symptoms (39% versus 62%; relative risk [RR] 0.63, 95% CI 0.41, 0.99; P = 0.043), and were more likely to experience adverse events (39% versus 16%; RR 2.47, 95% CI 1.12, 5.44; P = 0.024) compared to the orthoses group. Conclusion Prefabricated foot orthoses and rocker-sole footwear are similarly effective at reducing foot pain in people with first MTP joint OA. However, prefabricated foot orthoses may be the intervention of choice due to greater adherence and fewer associated adverse events.

46 citations


Journal ArticleDOI
TL;DR: Assessment of foot deformity, foot function and self-reported foot impairment may be of benefit when considering falls prevention strategies in people with RA.
Abstract: People with rheumatoid arthritis (RA) have an increased risk of falls. The foot is a common site of pathology in RA and foot problems are reported in up to 90 % of patients with established disease. The aim of this study was to determine whether foot and ankle characteristics are associated with falls in people with RA. Adults with RA were recruited from rheumatology outpatient clinics in Auckland, New Zealand. Participants reported whether they had fallen in the preceding year, and the number of falls. Clinical characteristics, common fall risk factors, and foot and ankle variables were measured. Univariate parametric and non-parametric analysis compared fallers and non-fallers on all variables to determine significant differences. Logistic regression analysis identified variables independently associated with falls. Two hundred and one participants were prospectively recruited. At least one fall in the preceding 12-months was reported by 119 (59 %) participants. Univariate analysis showed that fallers had significantly longer mean disease duration, more co-morbid conditions, an increase in lower limb tender joints, higher midfoot peak plantar pressures and were more likely to have a history of vascular disease than non-fallers. Fallers also reported greater difficulty with activities of daily living, increased fear of falling and greater self-reported foot impairment. Logistic regression analysis revealed that increased midfoot peak plantar pressures (odds ratio (OR) 1.12 [for each 20 kPa increase], 95 % confidence interval (CI) 1.00-1.25), self-reported foot impairment (OR 1.17 [for each three point increase], 95 % CI 1.05-1.31) and history of vascular disease (OR 3.22, 95 % CI 1.17-8.88) were independently associated with a fall in the preceding 12 months. Elevated midfoot peak plantar pressures, self-reported foot impairment and vascular disease are associated with falls in people with RA. Assessment of foot deformity, foot function and self-reported foot impairment may be of benefit when considering falls prevention strategies in people with RA. Australia New Zealand Clinical Trial Registry (trial ACTRN12612000597897 ).

27 citations


Journal ArticleDOI
TL;DR: In this paper, the authors investigated the existence of distinct foot osteoarthritis (OA) phenotypes based on pattern of joint involvement and comparative symptom and risk profiles, and found that polyarticular foot OA was associated with nodal OA, increased body mass index, and more pain and functional limitation compared to the other classes.
Abstract: Objective To investigate the existence of distinct foot osteoarthritis (OA) phenotypes based on pattern of joint involvement and comparative symptom and risk profiles. Methods Participants ages ≥50 years reporting foot pain in the previous year were drawn from a population-based cohort. Radiographs were scored for OA in the first metatarsophalangeal (MTP) joint, first and second cuneometatarsal, navicular first cuneiform, and talonavicular joints according to a published atlas. Chi-square tests established clustering, and odds ratios (ORs) examined symmetry and pairwise associations of radiographic OA in the feet. Distinct underlying classes of foot OA were investigated by latent class analysis (LCA) and their association with symptoms and risk factors was assessed. Results In 533 participants (mean age 64.9 years, 55.9% female) radiographic OA clustered across both feet (P < 0.001) and was highly symmetrical (adjusted OR 3.0, 95% confidence interval 2.1, 4.2). LCA identified 3 distinct classes of foot OA: no or minimal foot OA (64%), isolated first MTP joint OA (22%), and polyarticular foot OA (15%). After adjustment for age and sex, polyarticular foot OA was associated with nodal OA, increased body mass index, and more pain and functional limitation compared to the other classes. Conclusion Patterning of radiographic foot OA has provided insight into the existence of 2 forms of foot OA: isolated first MTP joint OA and polyarticular foot OA. The symptom and risk factor profiles in individuals with polyarticular foot OA indicate a possible distinctive phenotype of foot OA, but further research is needed to explore the characteristics of isolated first MTP joint and polyarticular foot OA.

27 citations


Journal ArticleDOI
TL;DR: To evaluate the effects of prefabricated foot orthoses and rocker‐sole footwear on spatiotemporal parameters, hip and knee kinematics, and plantar pressures in people with first metatarsophalangeal (MTP) joint osteoarthritis, a random allocation system was randomly allocated.
Abstract: Objective To evaluate the effects of prefabricated foot orthoses and rocker-sole footwear on spatiotemporal parameters, hip and knee kinematics, and plantar pressures in people with first metatarsophalangeal (MTP) joint osteoarthritis (OA). Methods. A total of 102 people with first MTP joint OA were randomly allocated to receive prefabricated foot orthoses or rocker-sole footwear. The immediate biomechanical effects of the interventions (compared to usual footwear) were examined using a wearable sensor motion analysis system and an in-shoe plantar pressure measurement system. Results Spatiotemporal/kinematic and plantar pressure data were available from 88 and 87 participants, respectively. The orthoses had minimal effect on spatiotemporal or kinematic parameters, while the rocker-sole footwear resulted in reduced cadence, percentage of the gait cycle spent in stance phase, and sagittal plane hip range of motion. The orthoses increased peak pressure under the midfoot and lesser toes. Both interventions significantly reduced peak pressure under the first MTP joint, and the rocker-sole shoes also reduced peak pressure under the second through fifth MTP joints and heel. When the effects of the orthoses and rocker-sole shoes were directly compared, there was no difference in peak pressure under the hallux, first MTP joint, or heel; however, the rocker-sole shoes exhibited lower peak pressure under the lesser toes, second through fifth MTP joints, and midfoot. Conclusion Prefabricated foot orthoses and rocker-sole footwear are effective at reducing peak pressure under the first MTP joint in people with first MTP joint OA, but achieve this through different mechanisms. Further research is required to determine whether these biomechanical changes result in improvements in symptoms.

27 citations


Journal ArticleDOI
TL;DR: This cross‐sectional study examined foot pain and severity of foot pain with depressive symptoms in adults in adults and found associations between pain and depression are well known.
Abstract: Objective Associations between pain and depression are well known, yet foot pain, common in populations, has been understudied. This cross-sectional study examined foot pain and severity of foot pain with depressive symptoms in adults. Methods Framingham Foot Study (2002–2008) participants completed questionnaires that included questions about foot pain (yes/no; none, mild, moderate, or severe pain) and the Center for Epidemiologic Studies Depression Scale (scores ≥16 indicated depressive symptoms). Age and body mass index (BMI) were also assessed. Sex-specific logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) for associations of foot pain with depressive symptoms, adjusting for age and BMI. In a subset, further models adjusted for leg pain, back pain, or other joint pain. Results Of 1,464 men and 1,857 women, the mean ± SD age was 66 ± 10 years. Depressive symptoms were reported in 21% of men and 27% of women. Compared to those with no foot pain and independent of age and BMI, both men and women with moderate foot pain had approximately a 2-fold increased odds of depressive symptoms (men with severe foot pain OR of 4 [95% CI 2.26–8.48], women with severe foot pain OR of 3 [95% CI 2.02–4.68]). Considering other pain regions attenuated ORs, but the pattern of results remained unchanged. Conclusion Even after we adjusted for age, BMI, and other regions of pain, those reporting worse foot pain were more likely to report depressive symptoms. These findings suggest that foot pain may be a part of a broader pain spectrum, with an impact beyond localized pain and discomfort.

24 citations


01 Jan 2016
TL;DR: To investigate the existence of distinct foot osteoarthritis phenotypes based on pattern of joint involvement and comparative symptom and risk profiles, a large number of patients with OA have had hip replacement surgery.

20 citations


Journal ArticleDOI
TL;DR: Strategies to reduce falls risk should be a priority in the year preceding lower limb joint surgery to optimize presurgery and postsurgery outcomes.

18 citations


Journal ArticleDOI
TL;DR: Evidence showed that MBT footwear caused asymptomatic individuals to walk with a shorter stride length, reduced peak hip flexion, increased peak knee extension, and reduced hip and knee range of motion throughout gait, and kinematic effects occurred in the sagittal plane.

Journal ArticleDOI
TL;DR: Foot pain, planus foot posture and pronated foot function are associated with self-reported difficulty undertaking common weight-bearing tasks and may have a role in improving mobility in community-dwelling older adults.
Abstract: Background: The foot plays an important role in supporting the body when undertaking weight-bearing activities. Aging is associated with an increased prevalence o

Journal ArticleDOI
TL;DR: Those with the highest risk of reporting foot pain in 2008–2010 were those with depressive symptoms, self-reported arthritis, high BMI,Self-reported upper limb pain and foot pain (in general or in specific regions of the foot) in 2004–2006.
Abstract: Foot pain has been shown to be prevalent across all age groups. The presence of foot pain may reduce mobility and impact on the ability to undertake activities of daily living. The aim of this study was to determine factors that are predictive of foot pain in a community based sample of the general population. This study analysed data from the North West Adelaide Health Study, a cohort study located in the northwestern suburbs of Adelaide, South Australia. Data were obtained between 2004–2006 and 2008–2010, using a self-completed questionnaire, computer assisted telephone interviewing, and a clinical assessment. The sensitivity, specificity and positive predictive values of variables were determined and generalised linear models ascertained the variables associated with the highest relative risk of self-reporting foot pain in 2008–2010 based on the data obtained in 2004–2006. The prevalence of foot pain in 2004–2006 was 14.9 % (95 % CI 13.6–16.4) and in 2008–2010, 29.9 % (95 % CI 27.5–32.5). Variables with the highest sensitivity were: female sex, ever having back pain, self-reported arthritis, body mass index (BMI) classified as obese and having foot pain in 2004–2006, while most variables demonstrated high specificity. Those with the highest risk of reporting foot pain in 2008–2010 were those with depressive symptoms, self-reported arthritis, high BMI, self-reported upper limb pain and foot pain (in general or in specific regions of the foot) in 2004–2006. Foot pain is common in the general population and those with the greatest risk of foot pain potentially represent a high level of chronicity and potential burden on the health system. Addressing the factors that predict foot pain, as well as the provision of targeted messages to highlight the importance of managing foot pain, may help reduce the impact on the population.

Journal ArticleDOI
TL;DR: Findings complement those in studies that have mainly examined women, and provide further evidence for the relationship between obesity and foot pain, that fat mass is associated with foot pain in men.
Abstract: OBJECTIVE: Foot pain is a common complaint in adults. Evidence suggests that body composition is involved in the development of foot pain. However, whether this is the case in men remains unclear because previous studies mainly examined women. The aim of this cross-sectional study was to determine the relationship between body composition and foot pain in men while accounting for important risk factors. METHODS: Among 978 men (median age 60 yrs, range 24-98) from the Geelong Osteoporosis Study who participated in a followup study in 2006 to 2011, 796 provided responses to questions on health status and foot pain. Foot pain was determined using the Manchester Foot Pain and Disability Index, and body composition was measured using dual-energy x-ray absorptiometry. RESULTS: Of the 796 respondents, 177 (22%) had foot pain. Risk factors for foot pain were age (OR 1.03, 95% CI 1.02-1.04), self-reported depression (OR 2.05, 95% CI 1.30-3.20), decreased mobility (OR 1.54, 95% CI 1.05-2.24), and lower education (OR 1.47, 95% CI 1.03-2.09). Foot pain was associated with body mass index (OR 1.05, 95% CI 1.00-1.10), fat mass (OR 1.02, 95% CI 1.03-1.05), and fat mass index (OR 1.08, 95% CI 1.01-1.15), but not fat-free mass (OR 1.01, 95% CI 0.98-1.04) or fat-free mass index (OR 1.05, 95% CI 0.95-1.15) after appropriate adjustments were made. CONCLUSION: Fat mass is associated with foot pain in men. These findings complement those in studies that have mainly examined women, and provide further evidence for the relationship between obesity and foot pain.

Journal ArticleDOI
Jasper W.K. Tong1, Veni P. Kong2, Lily Sze3, Susie Gale3, John Veto3, Carla McArdle3, Thanaporn Tunprasert4, Victoria Bradley5, Siobhan Strike6, Robert Ashford7, Robert Ashford8, Roozbeth Naemi7, Nachiappan Chocklingam7, Xavi de Blasc, Lisa Farndon, Vicki Robinson9, Emily Nicholls9, Tabitha Birch6, Ivan Birch, Simon Otter4, Sunil Kumar, Peter Gow, Nicola Dalbeth, Michael Corkill, Kevin A. Davies10, S. Panthakalam11, Maheswaran Rohan12, Keith Rome12, Chloe Egan13, Chloe Egan14, Lisa Chandler14, Peta Ellen Tehan15, Vivienne Chuter15, Jennifer A Sonter15, Sean M. Lanting15, Lorna Hicks16, Christopher Joyce17, David Watterson18, Caroline McIntosh17, Nigel Roberts17, Jacqueline Forss4, Chrystalla Charalambous4, Jack Kirby4, Oluwakemi Ojo4, Sarah Caukill4, Jacqueline Capon4, Radiance Fong4, Louis Loy4, Matthew Diment3, Madeleine Murray3, Mairghread Jh Ellis3, Christopher Oldmeadow15, Nicola Carey4, Karen Stenner, Heather Gage19, Jane Brown20, Peter Williams19, Ann Moore4, Jude Edwards19, Freda Mold19, Molly Courtenay21, Alan Bray, Pamela Hindmoor22, Craig R. Gwynne23, Sarah Curran23, Andy Bridgen24, Caroline Fairhurst25, Joy Adamson25, Belen Corbacho Martin25, Sarah Cockayne25, Catherine Hewitt25, Kate Hicks25, Anne-Maree Keenan26, Anne-Maree Keenan27, Lorraine Loughrey-Green26, Lorraine Loughrey-Green25, Hylton B. Menz28, Anthony C. Redmond27, Anthony C. Redmond26, Sara Rodgers25, Jude Watson25, David J. Torgerson25, Robin Hull29, Sarah Lamb30, Wesley Vernon, Gavin Wylie31, Gavin Wylie32, Zoe Young31, Brian Williams33, Frank Sullivan34, Simon Ogston32, Jacqui Morris33, Cathy Bowen35, Dorit Kunkel1, Mark Cole35, Margaret Donovan-Hall35, Ruth M. Pickering35, Malcolm Burnett35, Dan L. Bader35, Judy Robison35, Louis Mamode35, Ann Ashburn35, Peter McQueen36, Peter McQueen35, Maxine Daniels37, Michael Doherty38, Nigel K Arden36, Charlotte Dando39, Charlotte Dando35, Lindsey Cherry35, Lindsey Cherry39, Nichola Stefanou40, Sarah E Lamb30, Belen Corbacho25, Begonya Alcacer-Pitarch, Maya H Buch 
TL;DR: In this article, the authors investigated the relationship between proximal and distal factors in the development of patellofemoral joint pain and a whole body postural risk assessment in podiatry students.
Abstract: P3 Medial longitudinal arch development of school children Jasper W.K. Tong, Veni P. Kong P4 Is measuring the subtalar joint reliable? Lily Sze, Susie Gale, John Veto, Carla McArdle P5 Comparison of turning gait biomechanics between able-bodied and unilateral transtibial amputee participants Thanaporn Tunprasert, Victoria Bradley, Siobhan Strike P6 Comparison of walking gait biomechanics between able-bodied and unilateral transtibial amputee participants using a new model of energy-storage-and-return (ESAR) prosthetic Thanaporn Tunprasert, Victoria Bradley, Siobhan Strike P7 An observational study of in-shoe plantar and dorsal pressures of skilled downhill skiers on a dry ski slope Robert Ashford, Roozbeth Naemi, Nachiappan Chocklingam, Xavi de Blasc P8 If the shoe fits: a footwear choice toolkit informed by social science methodologies Lisa Farndon, Vicki Robinson, Emily Nicholls P9 The identification of emotions from gait Tabitha Birch, Ivan Birch P11 Experience of foot problems in patients with systemic lupus erythematosus Simon Otter, Sunil Kumar, Peter Gow, Nicola Dalbeth, Michael Corkill, Kevin Davies, Sam Panthakalam, Maheswaran Rohan, Keith Rome P14 Negative pressure wound therapy for the management of foot wounds in the diabetic population: a review of the literature Chloe Egan, Lisa Chandler P15 Lower limb vascular assessment in diabetes: a multifaceted assessment of objective screening techniques Peta Tehan, Vivienne Chuter, Jennifer Sonter, Sean Lanting P16 Improving outcomes for diabetes foot complications Lorna Hicks P17 Acupuncture… an alternative or adjunctive treatment option for diabetes-related neuropathic pain? Christopher Joyce, David Watterson, Caroline McIntosh P18 “My back is in agony” – A cross-sectional study into the relationship between musculoskeletal complaints and a whole body postural risk assessment in podiatry students Christopher Joyce, Nigel Roberts P19 Swabs of the treatment couches: Does the material type and texture of podiatric treatment couches increase microorganism contamination? Jacqueline Forss, Chrystalla Charalambous, Jack Kirby, Oluwakemi Ojo P20 Does increased exudate viscosity effect the absorption rate of exudate into four different wound dressings? Jacqueline Forss, Sarah Caukill, Jacqueline Capon, Radiance Fong, Louis Loy P21 An investigation into the microbial load of a 40 °C and 60 °C wash Matthew Diment, Madeleine Murray, Mairghread Ellis, Carla McArdle P23 The sensitivity and specificity of the toe brachial index in detecting peripheral arterial disease: a systematic review and meta-analysis Peta Tehan, Vivienne Chuter, Christopher Oldmeadow P24 Medicines management activities and non-medical prescribing within podiatry and physiotherapy: an integrative review of the literature Nicola Carey, Karen Stenner, Heather Gage, Jane Brown, Peter Williams, Simon Otter, Ann Moore, Jude Edwards, Freda Mold, Molly Courtenay A7.2 Non-invasive vascular assessment in the foot with Diabetes: Diagnostic accuracy of ankle brachial index, toe brachial index and continuous wave Doppler Peta Tehan, Alan Bray, Vivienne Chuter A7.5 The efficacy of dressings on post nail surgery phenolised wounds Pamela Hindmoor B7.1 Cross-sectional study investigating the role of proximal and distal factors in the development of patellofemoral joint pain Craig Gwynne, Sarah Curran B7.2 Podiatrist’s interpretation and use of evidence in MSK practice Andy Bridgen B7.4 Predictors of falling in older podiatry patients – findings from the REFORM study Caroline Fairhurst, Dr Joy Adamson, Belen Corbacho Martin, Sarah Cockayne, Prof Catherine Hewitt, Kate Hicks, Anne-Maree Keenan, Lorraine Loughrey-Green, Hylton Menz, Anthony Redmond, Sara Rodgers, Jude Watson, David Torgerson, Robin Hull, Sarah Lamb, Caroline McIntosh, Wesley Vernon, Lisa Farndon B7.5 The REFORM study: Insole preference, requirements and compliance of podiatry patient’s aged 65 and over and at risk of falling Lorraine Loughrey-Green, Sarah Cockayne, Anthony Redmond, Anne-Maree Keenan, Sara Rodgers, Lisa Farndon, Wesley Vernon, David Torgerson, Caroline Fairhurst, Jude Watson, Hylton Menz, Sarah Lamb, Robin Hull B7.6 A podiatry intervention to reduce falls in care home residents is feasible and demonstrates benefits: results from PIRFECT, a feasibility randomised controlled trial Gavin Wylie, Zoe Young, Brian Williams, Frank Sullivan, Hylton Menz, Simon Ogston, Jacqui Morris C7.1 A survey exploring footwear habits in people with stroke and people with Parkinson’s Cathy Bowen, Dorit Kunkel, Mark Cole, Margaret Donovan-Hall, Ruth Pickering, Malcolm Burnett, Dan Bader, Judy Robison, Louis Mamode, Ann Ashburn C7.2 Painful foot osteoarthritis; a common symptom in a common pathology? Peter McQueen, Maxine Daniels, Michael Doherty, Nigel Arden, Cathy Bowen C7.4 Clinical diagnosis of symptomatic forefoot neuroma in the general population: Delphi based recommendations Charlotte Dando, Lindsey Cherry, Cathy Bowen C7.5 The development and implementation of a Clinical Quality Improvement Framework suitable for use in community services Nichola Stefanou C7.6 The REFORM study - methodological considerations in running a cohort randomised controlled trial within a podiatry patient caseload Sarah Cockayne, Joy Adamson, Caroline Fairhurst, Catherine Hewitt, Anne-Maree Keenan, Sally Lamb, Lorraine Loughrey-Green, Caroline McIntosh, Hylton Menz, Anthony Redmond, Sara Rodgers, Wesley Vernon, Jude Watson, Lisa Farndon, Belen Corbacho, Robin Hull, David Torgerson A31 Jewel in the crown: Exploring the factors contributing to the development and impact of foot problems in Systemic Sclerosis (SSc) Begonya Alcacer-Pitarch, Anthony Redmond, Maya Buch, Anne-Maree Keenan

Journal ArticleDOI
TL;DR: It is hypothesized that each shank muscle has a specific activation pattern determined by its anatomical course around the axes of the subtalar and talo-crural joints, and the effect of foot posture on these activation patterns was examined.

Journal ArticleDOI
TL;DR: Full-length shoe stiffening inserts may be an effective intervention in first metatarsophalangeal joint osteoarthritis, however, further controlled studies are required.
Abstract: OBJECTIVE The objective of this study was to determine the feasibility of shoe stiffening inserts to reduce pain in first metatarsophalangeal joint osteoarthritis. DESIGN Thirty-one participants with first metatarsophalangeal joint osteoarthritis were prescribed shoe stiffening inserts and were evaluated at baseline and at 1 and 3 mos. The primary outcome measure was foot pain, assessed using the foot pain domain of the Foot Health Status Questionnaire (possible score ranges from 0 to 100). Secondary outcome measures included foot-related disability (foot function domain of the Foot Health Status Questionnaire), self-reported treatment effectiveness, use of rescue medication and other co-interventions, and adverse events. RESULTS At 1 and 3 mos, statistically significant improvements in foot pain and foot-related disability were observed (mean difference at 3 mos: foot pain = 18.8, 95% confidence interval, 13.3-24.3; foot function = 11.8, 95% confidence interval, 4.3-17.3). Treatment was reported to be effective by 78% of participants. Few participants (4%) reported using pain-relieving medication. Minor adverse events were reported by 30% of participants. CONCLUSIONS Full-length shoe stiffening inserts may be an effective intervention in first metatarsophalangeal joint osteoarthritis. However, further controlled studies are required.

Journal ArticleDOI
TL;DR: The KSPQ is a valid questionnaire to assess patients’ expected and desired outcomes of knee replacement surgery and their perception of their current abilities and function, and discrepancy between these.
Abstract: The discrepancy between patient-desired outcomes and achievable functional outcomes is a source of patient dissatisfaction. This paper reports development and validation of a questionnaire to assess this discrepancy in patients undergoing knee replacement surgery. The initial questionnaire (Knee Surgery Perception Questionnaire, KSPQ) comprised two parts. Part A, assessed patients’ perception of their current level of function and pain, and Part B, assessed patients’ desired outcomes of the surgery. Validation was carried out for Part A and then applied to Part B using a one-factor congeneric model and was tested in 185 patients preceding surgery. A discrepancy score between patients’ expectations and desired outcome (Part B) and their perception of current function (Part A) was also calculated. Pearson correlations were used between the KSPQ total score and subscales and other knee-specific questionnaires to determine construct validity. The final best set of models included four items for each subscale with a Chi-square value of 7.3 (n.s). The subscales and the total KSPQ showed significant strong to moderate correlations with knee-specific questionnaires. The discrepancy score in each subscale and the overall score showed relatively large discrepancy between patients’ expectations and their perception of current function; with higher discrepancy score reported for pain and walking. The KSPQ is a valid questionnaire to assess patients’ expected and desired outcomes of knee replacement surgery and their perception of their current abilities and function, and discrepancy between these. The KSPQ now requires further investigation at different stages of recovery following surgery. III.

Journal ArticleDOI
TL;DR: Joint pain and stiffness questions are reliable and can be used to determine prevalence, however, question wording and pain area may impact on estimates with issues such as pain perception and effect on activities playing a possible role in the recall of musculoskeletal pain.
Abstract: Case definition has long been an issue for comparability of results obtained for musculoskeletal pain prevalence, however the test-retest reliability of questions used to determine joint pain prevalence has not been examined. The objective of this study was to determine question reliability and the impact of question wording, ordering and the time between questions on responses. A Computer Assisted Telephone Interviewing (CATI) survey was used to re-administer questions collected as part of a population-based longitudinal cohort study. On two different occasions questions were asked of the same sample of 203 community dwelling respondents (which were initially randomly selected) aged 18 years and over at two time points 14 to 27 days apart (average 15 days). Reliability of the questions was assessed using Cohen’s kappa (κ) and intraclass correlation coefficient (ICC) and whether question wording and period effects existed was assessed using a crossover design. The self-reported prevalence of doctor diagnosed arthritis demonstrated excellent reliability (κ = 0.84 and κ = 0.79 for questionnaires 1 and 2 respectively). The reliability of questions relating to musculoskeletal pain and/or stiffness ranged from moderate to excellent for both types of questions, that is, those related to ever having joint pain on most days for at least a month (κ = 0.52 to κ = 0.95) and having pain and/or stiffness on most days for the last month (κ = 0.52 to κ = 0.90). However there was an effect of question wording on the results obtained for hand, foot and back pain and/or stiffness indicating that the area of pain may influence prevalence estimates. Joint pain and stiffness questions are reliable and can be used to determine prevalence. However, question wording and pain area may impact on estimates with issues such as pain perception and effect on activities playing a possible role in the recall of musculoskeletal pain.

Journal ArticleDOI
03 Jun 2016-BMJ
TL;DR: Patients with plantar fasciitis typically describe a sharp pain under the heel that is worse when taking their initial steps in the morning and eases after a few minutes of walking, but it may return on weight bearing after periods of inactivity during the day.
Abstract: #### What you need to know A 56 year old retail manager complains of four months of pain under her left heel. It is worse first thing in the morning and after sitting. About one in 10 people aged over 50 years report plantar heel pain.1 A recent ultrasound study of 175 feet with plantar heel pain in a secondary care population diagnosed plantar fasciitis in 73% of cases.2 The symptoms above are typical. ### Take a history Ask the patient where the pain is and what it feels like. Patients with plantar fasciitis typically describe a sharp pain under the heel. It may extend along the arch of the foot, from the insertion, along the length of the plantar fascia. Pain is worse when taking their initial steps in the morning and eases after a few minutes of walking, but it may return on weight bearing after periods of inactivity during the day. Symptoms are bilateral in about a third of cases.3 Explore alternative diagnoses. Trauma from landing on the heel from height can fracture the calcaneum, for example. Previous surgery to the area could lead to longstanding heel pain of iatrogenic causes. If there is pain elsewhere in the body, …


Journal ArticleDOI
TL;DR: The editors of Journal of Foot and Ankle Research would like to thank all the reviewers who have contributed to the journal in Volume 8 (2015).
Abstract: The editors of Journal of Foot and Ankle Research would like to thank all our reviewers who have contributed to the journal in Volume 8 (2015).