BackgroundChildren and young people make up an age group most vulnerable to falls. Various stability disorders may become instrumental in sustaining more frequent falls and resultant fractures. Correct morphological structure impacts overall efficiency of the foot, as well as offers significant diagnostic potential. Even minor foot disorders may affect the entire bio kinematic chain, also impacting the foot’s motility. Structural alterations within a foot may also impair balance in the standing position, and contribute to more frequent injuries. The study aimed to assess the relationship between feet deformities and postural stability deficits in schoolchildren prone to sustain accidental falls.MethodsThe study involved 200 children (101 girls and 99 boys) aged 10–15 years,randomly selected from primary schools. A 2D podoscan was used to assess the plantar part of the foot, while stabilometric examination was aided by the FreeMed dynamometric platform.ResultsCorrelation between respective variables was reflected by Spearman’s rank coefficient. The subjects’ age negatively correlated with the COP range of movement along the Y axis, and the COP surface area, while their BMI negatively correlated with the COP trajectory’s length. Step regression analysis indicated that the width of the left foot, the left foot Wejsflog index, the left foot Clark’s angle, the hallux valgus angle were the essential predictors of stabilometric variables in girls. In boys, though, predictive value was associated with Clarke’s angle of the left and right foot, Wejsflog index of the right foot, and the width of both the left and right foot.ConclusionsThere is a statistically significant correlation between morphological variables of the foot and postural stability. When assessing the key variables of the foot and their interrelationship with postural stability, the Clarke’s angle, Wejsflog index, hallux valgus angle, and foot width, should be granted due prominence in the girls. As regards the boys, the following variables were established as predictive in assessing postural stability: Clarke’s angle, Wejsflog index, and foot width.

Whereas inherently vulnerable structure of both a child's and an adolescent's foot, characteristic for its dynamic, developmental stage, is particularly exposed to numerous environmental factors, excessive body weight gain may potentially become a crucial causal factor, bringing on a cascade of adverse effects throughout the body, e.g. disorders of the skeletal-articular system, gait alterations, abnormally excessive loading of the plantar zones of the foot, and consequently serious postural defects, especially in later life. Since obesity, aptly dubbed the scourge of the 21st c., directly impacts the way the foot biomechanics are developed, whereupon the actual paradigm of foot loading becomes subject to numerous, adverse modifications, the present study focused on gaining an in-depth insight into prevalent association of BMi, adipose tissue content in body composition, and the actual distribution of foot loads in the school-aged children. Since body weight, the simplest anthropometric indicator, is actually non-indicative of the proportion of adipose tissue within body composition, a number of modern, non-invasive diagnostic methods were applied by the investigators to have this deficit effectively addressed, inclusive of comprehensively mapping out the actual load distribution in the plantar zones of the foot. The World Health Organization (WHO) acknowledges obesity to be the most common metabolic disease, aptly dubbing it a global scourge of the 21st c. This metabolic phenomenon has also affected children and teenagers. The number of overweight and obese cases in the youngsters aged 5-19 years increased from 4% in 1975 to over 18% in 2016. Obesity is a natural consequence of an imbalance between energy supply and its expenditure. Excessive dietary intake, usually combined with low physical activity, appreciably contribute to an increased weight gain through boosting the proportion of adipose tissue within the body composition 1-3. Excessive body weight appreciably contributes to abnormal motor development, agility, and overall coordination of movements, as well as adversely affects the development of the skeletal-articular system, which may consequently result in postural defects. Last but not least, excessive body weight may also be a crucial causal factor in various abnormalities encountered in the feet, i.e. abnormal foot loads 4-6. There are many studies corroborating detrimental effect of increased body weight on foot loads and attendant deformities 4-6. Numerous reports imply that overweight and obesity may well be instrumental in developing flat-footedness 7,8 , even though there are also studies which call this particular assertion into question 9. Cousins et al. 10 , while examining overweight and obese children observed that these children put more load on the metatarsal, in particular onto 2-5 metatarsal bones, than their peers with normal body weight. On the other hand, Buldt et al. 11 having conducted studies of adults with normal, flat, and cavus foot (i.e. a foot of high medial longitudinal arc...

The inclination angle of the lumbosacral spine, total curvature length, position of the apex of lordosis relative to S1, and S1-PL length (length of lordosis), appeared to be the least helpful in differentiating among postural types.

The study aimed to assess the association between the key predictive foot structure variables and its loading paradigm in 625 school-aged children. Clinical appraisal relied primarily on having the plantar parts of their feet comprehensively assessed with Podoscan 2D Foot CAD, and a dynamometer platform, the research tools of choice widely acknowledged for their overall accuracy and reliability, with a view to determining the distribution of respective foot loads, as well as addressing both balance and gait issues. The Clarke's angle, Wejsflog index, length and width of the feet, regardless of gender, proved the key predictive variables for the foot-loading paradigm. Notably the Clarke's angle, construed the most sensitive variable in assessing flat-footedness, offered an extra added value in overall investigative effort. The actual design of the study protocol effectively complements a standard clinical assessment procedure, whereas by comprehensively addressing those variables, it is also believed to aid clinicians in gaining an extra, hands-on, diagnostic potential, so that any teenagers exposed to the highest risk of developing foot deformities could effectively be identified through pertinent screening tests, and consequently offered a task-oriented, therapeutic management, specifically aimed at preventing potential postural complaints in later life.

Background Partial-thickness rotator cuff injuries (PTRCI) are the sum of degenerative, overload, and microtrauma processes. An external supply of collagen and platelet-rich plasma (PRP) could potentially counteract the deterioration of degenerative tendinopathy. This study aimed to compare the effectiveness of collagen with PRP, PRP alone, and collagen alone in the treatment of PTRCI. Methods Ninety patients with PTRCI were randomised and treated with ultrasound-guided injections into the shoulder bursa every consecutive week: Group A – collagen with PRP (n = 30), Group B – collagen alone (n = 30), and Group C – PRP alone (n = 30). Primary outcomes were pain intensity measured in control points on a numeric rating scale (NRS), QuickDash, and EQ-5D-5L questionnaires at the initial assessment (IA) and control assessments after 6 (T1), 12 (T2), and 24 (T3) weeks, respectively. Results No statistical differences were found between groups in primary outcomes, although there was a trend towards improvement in Groups A and C (opposite to Group B) between T2 and T3. The following parameters were also observed: rotator cuff discontinuity (n = 3, one case in each group) and rotator cuff regeneration (n = 22 in Group A, n = 20 in Group B, and n = 23 in Group C). Conclusions Combined therapy of collagen and PRP in PTRCI presents similar effectiveness to monotherapies with collagen or PRP. Trial registration The study was prospectively registered on the NCT Trial Center (identification number: NCT04492748) on 30.07.2020.