Progressive pseudorheumatoid dysplasia (PPRD) is an autosomal recessive inherited skeletal dysplasia characterized by progressive non-inflammatory arthropathy affecting primarily the articular cartilage. Currently, little is known about the functional musculoskeletal aspects of these patients. In particular, an abnormal gait pattern has been described, without a clear hypothesis of the underlying causes in terms of muscular activity. This study presents the case of two siblings, 4 and 9 years old, a boy and a girl, respectively, suffering from PPRD at different stages of the disease. In addition to the clinical assessment, an instrumental gait analysis was performed. Swelling of the interphalangeal finger joints and fatigue were present in both cases. Gait abnormalities consisted of a relevant reduction in the ankle plantarflexion in the terminal phase of the gait cycle, associated with reduced gastrocnemius EMG activity and increased activity of the tibialis anterior, resulting in overloading at the initial peak of ground reaction forces. Gait anomalies observed were similar in both siblings with PPRD, although at different ages, and confirm walking patterns previously described in the literature. The calf muscle strength deficit and reduced activity during the stance phase of gait present in these two siblings indicate the typical absence of the propulsive phase. A stomping gait pattern, with the foot striking the ground hard on each step, was originally described. Further neurophysiological investigations are required to determine the origin of muscle weakness.

Background. The use of five-toed socks can be a valid prevention option against interdigital problems and a valuable sensory stimulus in walking. However, nowadays, they are hardly ever suggested because they are often little known or disregarded by clinicians dealing with podiatric problems. The aim. This scoping review aims to map and summarise the literature to identify interventions using five-toed socks Methods. Four databases were searched up to December 2022. Studies that considered the use of five-toed socks could be included. All interventions and contexts were considered. No restrictions were applied regarding language, study design and publication type. Grey literature and reference lists of included articles were not identified. The results were presented in numerical and thematic form. Results. Out of 23 initially identified studies, only 4 met the inclusion criteria for this scoping review. The majority of the included articles were randomized controlled trials (RCTs) and involved participants of different ages, including both sporty and non-sporty individuals, who used five-toed socks as part of the intervention. It is worth noting that the authors focused solely on conservative interventions, with all 4 studies investigating the effects of wearing five-toed socks for more than one week. Conclusions. This is the first scoping review to provide a comprehensive overview of the topic. The results revealed clear gaps in primary research, confirming that current management is based on knowledge of five-toed socks. This review may be useful for general management and may provide a starting point for future research. Keywords: foot care, foot problems, five-toed socks, toes.

Background The treatment of lymphoedema requires a multi-professional and interdisciplinary approach. Despite being prescribed in the management of lymphatic disorders, the effectiveness of the phlebological insoles is still under investigation. Aim This scoping review aims to identify and analyse evidence regarding the efficacy of phlebological insoles as a conservative intervention for lower limb lymphoedema. Method The following databases were searched up to November 2022: PubMed, Cochrane Library, CINAHL Complete, PEDro and Scopus. Preventive and conservative interventions were considered. Studies considering people with lower limb oedema, of any age and type of oedema, were eligible for inclusion. No restrictions in terms of language, year of publication, study design and type of publication were applied. Additional studies were sought through grey literature. Results From 117 initial records, 3 studies met the inclusion criteria. Two quasi-experimental studies and one randomised cross-over study were included. The results of the examined studies confirmed the positive effects of insoles usage and foot and ankle mobility on the venous return. Conclusion This scoping review provided an overview of the topic. The studies analysed in this scoping review have shown that insoles seem to be beneficial in reducing the lower limb oedema in healthy individuals. However, there are still no comprehensive trials confirming this evidence on people with lymphoedema. The small number of identified articles, the selection of participants not affected by lymphoedema, the use of heterogeneous devices in terms of modifications and materials highlight the need of further investigations. Future trails should include people affected by lymphoedema, address the choice of materials in manufacturing the insoles and take in consideration the patients’ adherence to the device and concordance to the treatment.

Background Lymphedema is a chronic progressive disease that results in interstitial edema in the limbs, and to a lesser extent in the genitals and face, due to damage to the lymphatic system. Methods Research was conducted between July 2022 and September 2022 in biomedical databases: PubMed, Cochrane Central Register of Controlled Trials (Cochrane Library), and PEDro. Results Two studies showed that lymphedema alters gait parameters by affecting mainly kinematic parameters, although kinetic parameters were found to be significantly altered, especially in patients with severe lymphedema. In other studies, using methods such as videos and questionnaires, difficulties in walking were found in the presence of lymphedema. The most common abnormality was antalgic gait. Conclusions Poor mobility can worsen the edema, which, in turn, can compromise joint range of motion. Gait analysis is an essential tool to evaluate and follow.

BackgroundLimitation of tibio-tarsal joint mobility in diabetic patients can occur within a few years of diagnosis, even in young patients. Case presentationA patient with type 2 diabetes.ConclusionsThe results suggest that the role of manual treatment combined with an exercise programme could increase tarsal dorsiflexion and consequently decrease plantar pressures.