Sever's disease, or Calcaneal Apophysitis, is a common condition affecting children. It has been examined at a review level at best since first being described in 1907. The aim of this study was to compare the characteristics of a group of children with Sever's disease with a non-symptomatic group of children of similar age. This prospective study had two main objectives. Firstly, to examine issues which had been anecdotally raised in the literature over the years; secondly, to determine the quality of life effects on children with Sever's disease. / A literature review of Sever's disease articles was undertaken to identify what was known, and what was surmised about the disease. The literature was also reviewed to allow selection of the correct tools to determine if there were any differences between the two groups of children. Issues such as reliability and validity as well as suitability of questionnaires were examined and justified from the literature. / Several areas arose which the literature did not adequately cover, including the reliability of foot measures, validity of a new measure - the Foot Posture Index, and a reliable and valid way to measure the dorsiflexion of the foot on the leg. Experiment 1 established that the intra rater reliability of the measurements to be used in Experiment 4 was good, but that the inter rater reliability was poor to moderate. Experiment 2 investigated the criterion validity of four components of the foot Posture Index, a new measurement that was to be used in Experiment 4, concluding that gross movements could be shown, but not subtle foot position changes. Experiment 3 developed equipment for the measurement of ankle joint dorsiflexion, another parameter to be measured in Experiment 4, and established that the intra and inter rater reliability of this apparatus was excellent. / Experiment 4 involved the gathering of data relating to Body Mass Index, activity, foot posture, traditional foot measures, ankle joint dorsiflexion and quality of life from the two aforementioned groups. Binary logistic regression was used to determine the odds ratios of various factors for the Sever's disease and non-Sever's disease group. The only significant differences between the groups were in quality of life scales and in forefoot to rearfoot determination. The implications of these findings are discussed. / Thesis (PhD)--University of South Australia, 2006.

Thesis (M.A.)--University of Missouri-Columbia, 2008. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on August 13, 2009) Includes bibliographical references.

Title The effect of wearing high heel shoes on pelvis motion. Aim The main aim of this work is the verification of the influence of wearing high heel shoes on pelvis motion in the sagittal plane, while walking on high heel shoes and walking on unmeasured high heel less shoes yet. After then, we want to monitori the impact of walking in these shoes on the trajectory of pelvis motion. Methods Objectification method was 3D record of human gait (= kinematic analysis), which was performed using the Qualisys. In our thesis we used the method of comparison. The aim of the study is the comparison of parameters measured in different types of shoes (high heeled shoes, high heeled less shoes with barefoot gait) and the influence on pelvis motion. Results Pelvis tilt to retroversion was more significant when walking on high heel less shoes compared with high heel shoes and barefooted walking, also an angle of the trunk and pelvis were most significantly diminished when walking on high heel less shoes compared to barefooted walking and high heel shoes. Objectively, a larger deflection of pelvis trajectory while walking on high heel shoes was not confirmed compared to walking on high heel less shoes. The average length of steps was most reduced when walking on high heel shoes, a little less when walking on HHL...

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Human bipedal locomotion is characterized by a habitual heel-strike (HS) plantigrade gait, yet the significance of walking foot-posture is not well understood. To date, researchers have not fully investigated the costs of non-heel-strike (NHS) walking. Therefore, we examined walking speed, walk-to-run transition speed, estimated locomotor costs (lower limb muscle volume activated during walking), impact transient (rapid increase in ground force at touchdown) and effective limb length (ELL) in subjects (n=14) who walked at self-selected speeds using HS and NHS gaits. HS walking increases ELL compared with NHS walking since the center of pressure translates anteriorly from heel touchdown to toe-off. NHS gaits led to decreased absolutewalking speeds (P=0.012) and walk-to-run transition speeds (P=0.0025), and increased estimated locomotor energy costs (P<0.0001) compared with HS gaits. These differences lost significance after using the dynamic similarity hypothesis to account for the effects of foot landing posture on ELL. Thus, reduced locomotor costs and increased maximum walking speeds in HS gaits are linked to the increased ELL compared with NHS gaits. However, HS walking significantly increases impact transient values at all speeds (P<0.0001). These trade-offs may be key to understanding the functional benefits of HS walking. Given the current debate over the locomotor mechanics of early hominins and the range of foot landing postures used by nonhuman apes, we suggest the consistent use of HS gaits provides key locomotor advantages to striding bipeds and may have appeared early in hominin evolution.

Infants in the NICU undergo many painful procedures and literature supports KMC as an effective intervention to diminish pain however, it is not used routinely in NICUs. The purpose of this qualitative study is to provide NICU nurses an opportunity to describe their experience of utilizing KMC for pain, and to interpret this experience with the goal of generating patterns that explain this understanding. The findings can be used to formulate interventions that foster the use of KMC. Using Interpretive Description as a philosophy of inquiry and research methodology, 8 NICU nurses were interviewed and participated in a focus group. Four patterns emerged: (1)”Seeing is Believing”; (2) Human Heartedness: “It’s the Least I can do”; (3) Playing it Safe; and (3) Creating the Possibility within Constraints.

One major way that running style varies between individuals is how their foot strikes the ground (forefoot strike or rearfoot strike). Running generates a torque about the ankle that depends on the individual’s foot strike pattern, length of their plantar flexor moment arm, and force generated from the plantar flexor muscles. The foot strike pattern during running, gastrocnemii muscle thickness, and heel length (used as an approximation for plantar flexor moment arm) were determined in 41 runners. Forefoot and rearfoot strike runners had the same thickness of the gastrocnemii muscles. However, in comparison with sedentary walkers, the runners had thicker calf muscles. These results imply a “peak” muscle thickness seems to be attained by running. Runners with longer heels were more likely to use a forefoot strike running style, possibly due to a mechanical advantage in the generation of torque.

The aim of the current study is to investigate novel therapeutic/treatment methods and outcome measurement for children with Idiopathic Toe Walking (ITW). Fifteen typically developing (TD) children and 15 children with ITW, aged between 4 to 10 years old, participated. The participants performed a gait exam including 30 barefoot walking trials over three 4-meter walkways before and after a whole-body vibration intervention. Vibration perception threshold tests were also conducted before and after the vibration intervention. In the gait exams, each of the walking surfaces represented a different tactile stimulus and the vibration intervention included standing on a whole body vibration platform for 60 seconds. Kinematics were collected at 100 Hz with a seven-camera 3-D motion analysis system. Walking surface and vibration intervention were the independent variables. Temporal-spatial gait parameters such as velocity, cadence, step length, and step width were measured. Heel rise occurrence (HR32) and vibration perception threshold (VPT) were also calculated as dependent variables. Walking surface significantly altered the gait parameter of both TD children and children with ITW. Vibration intervention altered the VPT scores of both TD children and children with ITW. Manipulated surface and excessive vibration may be important in the development of therapeutic/treatment methods for children with Idiopathic Toe Walking. HR32 is a novel calculation designed to distinguish on aspect of the toe-walking gait pattern. It significantly identified toe-walking patterns and quantified treatment results. Children with ITW appeared to have less toe-walking on the gravel surface. Walking on gravel surface is a potential novel method to reduce toe-walking immediately with no negative after-effects.

INTRODUCTION: Coupling in the distal foot may be due, at least in part, to the foot's windlass mechanism. This mechanism has been demonstrated passively, but its role in dynamic movement is still unclear. A systematic manipulation of metatarsophalangeal (MTP) mechanics may help determine to what extent distal foot coupling during dynamic and active movement is due to the windlass mechanism versus active muscle contractions or springlike ligaments. Furthermore, exploring the windlass mechanism in feet with varying foot structure may aid our understanding of the relationship between foot structure and foot function. PURPOSE: The overall purpose of this study is to investigate the kinematic and kinetic coupling between the MTP and midtarsal joints through a systematic manipulation of the windlass mechanism (achieved through methodical changes to MTP motion). Additionally, we aimed to explore the relationship between foot structure and the efficacy of the windlass mechanism during passive, active, and dynamic movement. METHODS: First, arch height and flexibility were measured using the Arch Height Index Measurement System. Next, participants performed four order-randomized conditions where MTP extension was isolated: 1) Seated Passive MTP Extension, 2) Seated Active MTP Extension, 3) Standing Passive MTP Extension, and 4) Standing Active MTP Extension. Lastly, participants performed three heel raise conditions that manipulated the starting position of the MTP joint: 1) Neutral: normal heel raise, 2) ToeExt: heel raise with the toes placed on an inclined surface of 30 degrees to put the MTP joint into extension, and 3) ToeFlex: heel raise with the toes placed on a declined surface of 30 degrees to put the MTP joint into flexion. All conditions were performed to a metronome of 40 beats per minute to control angular velocity. A kinetic multisegment foot model was created in Visual 3D software and used to calculate ankle, midtarsal, and MTP joint angles, moments, powers, and work. RESULTS: Kinematic coupling was approximately six times greater in the heel raise conditions compared to the isolated MTP extension conditions and suggests that the windlass mechanism only plays a small role in dynamic tasks. This is likely due to the greater involvement of active muscle contractions during heel raises. As the starting position of the MTP joint became increasingly extended, the amount of negative work at the MTP joint increased concomitantly with increased positive work done at the midtarsal joint, while net distal-to-hindfoot work remained unchanged. Our combined results suggest that there is substantial coupling within the distal foot, but this coupling is likely attributed to more than simple passive energy transfer from the windlass mechanism. Future investigations into the intrinsic foot muscle activation and biarticular muscle effects are likely needed to determine the source of this coupling. Lastly, the relationship between foot structure and function is still unclear and our results suggest that arch height or arch flexibility alone may not be adequate predictors of dynamic foot function.