Bakgrund Droppfot är vanligt vid många sjukdomar och tillstånd, och resulterar i en oförmåga att dorsalextendera fotleden. I vissa fall måste en sentransferering av tibialis posterior utföras för att återställa förmågan att dorsalextendera. Operationen utförs på olika sätt, är väldokumenterad och väl beforskad. För att operationen ska ge önskat resultat krävs god rehabilitering postoperativt. Rehabiliteringen är mindre dokumenterad och saknar tydliga direktiv att förhålla sig till.  Syfte Syftet med denna scoping review var att sammanställa och granska den tillgängliga kunskapen angående rehabiliteringen efter en sentransferering av tibialis posterior.   Metod En scoping review valdes som studiedesign då artikelutbudet är begränsat. Studien utfördes enligt riktlinjer av Arksey & O’Malley (2005), samt Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA).  Resultat Resultatet av sökningen och artikelurvalet på 28 artiklar visade på en stor inkonsekvens i hur rehabiliteringen utförs. De data som extraherades var; antal deltagare, typ av operation, belastning postoperativt, immobiliseringstid, samt beskrivning av fysioterapeutiska insatser. Vissa studier vittnar om 11-12 veckors immobilisering i gips, medan andra mobiliserar inom en vecka postoperativt och undviker att gipsa. Den stora inkonsekvensen kan delvis förklaras med att deltagarnas grunddiagnoser varierar mellan de inkluderade studierna, samt att de kirurgiska tillvägagångssätten skilde sig åt, samt inkluderade andra operationer. Endast två studier behandlade rehabiliteringen som sitt huvudsyfte. Slutsats Bristfällig forskning finns för att kunna dra några vetenskapliga slutsatser. Mer forskning behövs, både som adresserar fysioterapeutiska interventioner och rehabiliteringsfasen i helhet. Mer specifik forskning gällande rehabiliteringen vid sentransferering av tibialis posterior med beaktande av de enskilda diagnoserna behövs också.

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第21042号 / 人健博第58号 / 新制||人健||4(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 坪山 直生, 教授 黒木 裕士, 教授 松田 秀一 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

Introduction: Foot over-pronation, attributable to Tibialis Posterior (TP) muscle weakness, is a possible cause of medial tibial stress syndrome (MTSS)3. Taping may provide a viable alternative for a dysfunctional TP and its associated navicular drop (ND). The most commonly used Augmented LowDye (ALD) technique has shown to prevent ND, but is time- and cost- intensive, leading us to explore an alternative technique. The purpose of this study was to assess the effectiveness of a new, anti-pronation (AP) taping technique, as compared to the ALD, to (a) reduce or prevent ND and (b) cause a lateral shift in the center of pressure (COP) measures. Methods: This is a 2 (tape techniques) by 3 (time: baseline, tape/pre-exercise, and tape/post-exercise) controlled laboratory study design. Twenty symptomatic (ND >/= 10 mm) college-age subjects were prepared with one of the 2 tape techniques and/or control and performed the ND test three times and walk across a pressure mat five times. Then the participants fatigued the tape by walking on a treadmill for 15 minutes at 3.0 mph at 0% grade and ND and pressure mat readings were recorded again. A within and within ANOVA allowed for the examination of between and within comparisons and a functional analysis (lateral shift as a function of time) on the mat-generated data were done p<.05. Results: Results revealed significant differences across times, and a times-by-tape technique interaction but differences between tape techniques were not significant. M and SD and indicate that while both taping techniques reduced ND, only the AP technique was significantly different (HSDTukey (3,76)=1.44, p<.01) for every comparison other than AP pre-exercise, the mean lateral shift for the treatment was not significantly different from the control across any part of the normalized stance phase, but was significantly lower than the control in the 30-90% interval in the AP pre-exercise. Discussion: The AP technique not only controlled ND but also resulted in an increase in lateral excursion of the COP line during that portion of the stance phase associated with the structures and functions of the TP. Both techniques can be appropriately used but that the AP can be used with more confidence in its effectiveness. The MatScan has allowed examination of forefoot pronation in the horizontal plane, not just the vertical plane, yielding a more holistic analysis of forefoot pronation. Being able to analyze data in a functional fashion (i.e., lateral shift as a function of time) could allow researchers greater insights to the complex relationships between biomechanical movement and appropriate interventions.

Introduction: The New Balance Core Low Cut Sock (New Balance Athletic Shoe, Inc. · Boston, MA United States) is one of many arch support socks out in the market. These socks have an elastic portion, called a Stability Fit Arch Support & Hold technology, which has been incorporated into the arch area of the sock. The company makes the following claim that the socks provide, "Gentle compression to support the arch, relieving arch-related pain and discomfort."1 If these socks do provide adequate arch support, then they would allow individuals the ability to have an inexpensive method of arch support that is easy to apply and use. The purpose of this study is to test the effectiveness of these socks in (a) navicular drop (b) static pressure insole pressure profiles and (c) dynamic (walking and running) pressure insole pressure profiles. Methods: Eighteen symptomatic, college age (age 18-26) subjects were used in this study (seven male, eleven female), with symptomatic being defined as a navicular drop greater than or equal to 10 mm. Measurements were collected for both the navicular drop, and F-Scan insole data, for both static and dynamic stance. For walking and running trials, heel strike and toe off were identified by the Tekscan System and COP excursion coordinates evaluated throughout the stance phase. The COP coordinates were exported then compared over the stance phase. A series of functional analyses was used to assess the between group differences. A paired t-test was used to assess the within group differences. Results: Results indicate that the arch support socks were not significantly different from the control (regular socks) along any part of the foot strike (95% confidence) in any of the conditions (standing, walking or running). Results from the paired t-test revealed no significant differences in navicular drop between sock types (p = .379). Discussion: This study found that the elastic band in the New Balance socks did not provide increased support to the medial arch of the foot compared to the control sock in either the navicular drop paired t-test or the functional analysis of the static and dynamic data. The authors could not find any other comparable study on these kinds of socks. Compared to other reports, using both orthotic inserts and tape, ND was reduced, unlike the results found in the present study. 2 Our data are inconsistent with the idea that increased elastic support to the midfoot by these socks provides significant arch support. The authors would suggest another form of arch support such as orthotics or taping to aid on arch support rather than these socks.

No description available.

Title: Acquired flatfoot in adults Background: Flatfoot deformity is one of the common diagnoses in the orthopedic field and physiotherapy, its common in adults as acquired, there is still a large incidence of flatfoot in adolescence and many cases of adult flatfoot are frequently presented as residual pediatric flatfoot. The treatment also has wide field according to type of cause. Aims: The aim of this literature review was to enhance knowledge on the persistence of the acquired flatfoot condition in adult's population by determining the causes of flatfoot with contributing factors that affect the medial longitudinal arch and progression of the deformity, and review of the most common treatment. Method: An electronic database search was conducted to obtain articles from relevant journals (from early 1990 to end 2015). The information was collected also from textbooks. Results: Regarding the causes of acquired flatfoot in adult, a good base of evidence stems from a number of articles review, the posterior tibialis tendon dysfunction is the most cause of acquired flatfoot. The sensory motor stimulation technique is not the most treatment used to treat acquired flatfoot in adults and the most used treatment is the surgical procedure. Conclusion: Regarding the causes of adults acquired flatfoot in...