PKa1:f refs.MYD <7)Carcia, C. R. Martin, R. L. Drouin, J. M.2008YValidity of the Foot and Ankle Ability Measure in athletes with chronic ankle instability179-83 J Athl Train432Activities of Daily Living Adult Ankle/*physiology Ankle Injuries/*physiopathology Chronic Disease Female Foot/*physiology Health Status Health Status Indicators Humans Joint Instability/*physiopathology Male *Outcome Assessment (Health Care) Questionnaires *Sports Sports MedicineApr-JunCONTEXT: The Foot and Ankle Ability Measure (FAAM) is a region-specific, non-disease-specific outcome instrument that possesses many of the clinimetric qualities recommended for an outcome instrument. Evidence of validity to support the use of the FAAM is available in individuals with a wide array of ankle and foot disorders. However, additional evidence to support the use of the FAAM for those with chronic ankle instability (CAI) is needed. OBJECTIVE: To provide evidence of construct validity for the FAAM based on hypothesis testing in athletes with CAI. DESIGN: Between-groups comparison. SETTING: Athletic training room. PATIENTS OR OTHER PARTICIPANTS: Thirty National Collegiate Athletic Association Division II athletes (16 men, 14 women) from one university. MAIN OUTCOME MEASURE(S): The FAAM including activities of daily living (ADL) and sports subscales and the global and categorical ratings of function. RESULTS: For both the ADL and sports subscales, FAAM scores were greater in healthy participants (100 +/- 0.0 and 99 +/- 3.5, respectively) than in subjects with CAI (88 +/- 7.7 and 76 +/- 12.7, respectively; P < .001). Similarly, for both ADL and sports subscales, FAAM scores were greater in athletes who indicated that their ankles were normal (98 +/- 6.3 and 96 +/- 6.9, respectively) than in those who classified their ankles as either nearly normal or abnormal (87 +/- 6.6 and 71 +/- 11.1, respectively; P < .001). We found relationships between FAAM scores and self-reported global ratings of function for both ADL and sports subscales. Relationships were stronger when all athletes, rather than just those with CAI, were included in the analyses. CONCLUSIONS: The FAAM may be used to detect self-reported functional deficits related to CAI.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18345343 0Journal Article Validation Studies United States1062-6050 (Print)Journal of athletic training18345343]Department of Physical Therapy, Duquesne University Pittsburgh, PA 15282, USA. carcia@duq.edueng<7Martin, R. L. Irrgang, J. J.2007DA survey of self-reported outcome instruments for the foot and ankle72-84J Orthop Sports Phys Ther372*Ankle *Foot Humans *Outcome Assessment (Health Care) *Questionnaires Reproducibility of Results *Self Disclosure United StatesFeb[The information acquired from self-reported outcome instruments is useful only if there is evidence to support the interpretation of obtained scores. To properly interpret scores, there should be evidence for content validity, construct validity, reliability, and responsiveness. Evidence regarding score interpretation must also contain a description of the applicable test conditions, including information about the characteristics of subjects, timing of data collection, and construct of change. The objective of this review was to identify self-reported outcome instruments that have evidence to support their usefulness for assessingthe effect of treatment directed at individuals with foot and ankle-related pathologic conditions in an orthopaedic physical therapy setting. In addition, we provide specific information that will allow clinicians and researchers to select an appropriate instrument and properly interpret the obtained scores. Fourteen self-reported outcome instruments that met the objective of this review were identified. Five instruments, the Foot and Ankle Ability Measure, Foot Function index, Foot Health Status Questionnaire, Lower Extremity Function Scale, and Sports Ankle Rating System quality of life measure, satisfied all 4 categories of evidence (content validity, construct validity, reliability, and responsiveness) outlined herein.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17366962 $Journal Article Review United States0190-6011 (Print)6The Journal of orthopaedic and sports physical therapy17366962bDepartment of Physical Therapy, Duquesne University, Pittsburgh, PA 15282, USA. martinr280@duq.edueng<75Martin, R. L. Irrgang, J. J. Lalonde, K. A. Conti, S.2006;Current concepts review: foot and ankle outcome instruments383-90Foot Ankle Int275{Foot Diseases/*therapy Humans Outcome Assessment (Health Care)/classification/methods/*standards Reproducibility of ResultsMayfhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16701063 $Journal Article Review United States1071-1007 (Print)kFoot & ankle international / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society16701063Department of Physical Therapy, Duquesne University, 114 Rangos School of Health Sciences, Pittsburgh, PA 15282, USA. martinr280@duq.edueng <7NMartin, R. L. Irrgang, J. J. Burdett, R. G. Conti, S. F. Van Swearingen, J. M.2005BEvidence of validity for the Foot and Ankle Ability Measure (FAAM)968-83Foot Ankle Int2611'Activities of Daily Living Adolescent Adult Aged Aged, 80 and over Ankle/*physiopathology Child Female Foot/*physiopathology Humans Male Middle Aged Mobility Limitation Musculoskeletal Diseases/*physiopathology Questionnaires/*standards Reproducibility of Results *Sickness Impact Profile SportsNovuBACKGROUND: There is no universally accepted instrument that can be used to evaluate changes in self-reported physical function for individuals with leg, ankle, and foot musculoskeletal disorders. The objective of this study was to develop an instrument to meet this need: the Foot and Ankle Ability Measure (FAAM). Additionally, this study was designed to provide validity evidence for interpretation of FAAM scores. METHODS: Final item reduction was completed using item response theory with 1027 subjects. Validity evidence was provided by 164 subjects that were expected to change and 79 subjects that were expected to remain stable. These subjects were given the FAAM and SF-36 to complete on two occasions 4 weeks apart. RESULTS: The final version of the FAAM consists of the 21-item activities of daily living (ADL) and 8-item Sports subscales, which together produced information across the spectrum ability. Validity evidence was provided for test content, internal structure, score stability, and responsiveness. Test retest reliability was 0.89 and 0.87 for the ADL and Sports subscales, respectively. The minimal detectable change based on a 95% confidence interval was +/-5.7 and +/--12.3 points for the ADL and Sports subscales, respectively. Two-way repeated measures ANOVA and ROC analysis found both the ADL and Sports subscales were responsive to changes in status (p < 0.05). The minimal clinically important differences were 8 and 9 points for the ADL and Sports subscales, respectively. Guyatt responsive index and ROC analysis found the ADL subscale was more responsive than general measures of physical function while the Sports subscale was not. The ADL and Sport subscales demonstrated strong relationships with the SF-36 physical function subscale (r = 0.84, 0.78) and physical component summary score (r = 0.78, 0.80) and weak relationships with the SF-36 mental function subscale (r = 0.18, 0.11) and mental component summary score (r = 0.05, -0.02). CONCLUSIONS: The FAAM is a reliable, responsive, and valid measure of physical function for individuals with a broad range of musculoskeletal disorders of the lower leg, foot, and ankle.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16309613 0Journal Article Validation Studies United States1071-1007 (Print)kFoot & ankle international / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society16309613rDuquesne University, Physical Therapy, 600 Forbes Avenue, 111A RSHS, Pittsburgh, PA 15282, USA. martinr280@duq.edueng <7NMartin, R. L. Irrgang, J. J. Burdett, R. G. Conti, S. F. Van Swearingen, J. M.2005BEvidence of validity for the Foot and Ankle Ability Measure (FAAM)968-83Foot Ankle Int2611'Activities of Daily Living Adolescent Adult Aged Aged, 80 and over Ankle/*physiopathology Child Female Foot/*physiopathology Humans Male Middle Aged Mobility Limitation Musculoskeletal Diseases/*physiopathology Questionnaires/*standards Reproducibility of Results *Sickness Impact Profile SportsNovuBACKGROUND: There is no universally accepted instrument that can be used to evaluate changes in self-reported physical function for individuals with leg, ankle, and foot musculoskeletal disorders. The objective of this study was to develop an instrument to meet this need: the Foot and Ankle Ability Measure (FAAM). Additionally, this study was designed to provide validity evidence for interpretation of FAAM scores. METHODS: Final item reduction was completed using item response theory with 1027 subjects. Validity evidence was provided by 164 subjects that were expected to change and 79 subjects that were expected to remain stable. These subjects were given the FAAM and SF-36 to complete on two occasions 4 weeks apart. RESULTS: The final version of the FAAM consists of the 21-item activities of daily living (ADL) and 8-item Sports subscales, which together produced information across the spectrum ability. Validity evidence was provided for test content, internal structure, score stability, and responsiveness. Test retest reliability was 0.89 and 0.87 for the ADL and Sports subscales, respectively. The minimal detectable change based on a 95% confidence interval was +/-5.7 and +/--12.3 points for the ADL and Sports subscales, respectively. Two-way repeated measures ANOVA and ROC analysis found both the ADL and Sports subscales were responsive to changes in status (p < 0.05). The minimal clinically important differences were 8 and 9 points for the ADL and Sports subscales, respectively. Guyatt responsive index and ROC analysis found the ADL subscale was more responsive than general measures of physical function while the Sports subscale was not. The ADL and Sport subscales demonstrated strong relationships with the SF-36 physical function subscale (r = 0.84, 0.78) and physical component summary score (r = 0.78, 0.80) and weak relationships with the SF-36 mental function subscale (r = 0.18, 0.11) and mental component summary score (r = 0.05, -0.02). CONCLUSIONS: The FAAM is a reliable, responsive, and valid measure of physical function for individuals with a broad range of musculoskeletal disorders of the lower leg, foot, and ankle.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16309613 0Journal Article Validation Studies United States1071-1007 (Print)kFoot & ankle international / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society16309613rDuquesne University, Physical Therapy, 600 Forbes Avenue, 111A RSHS, Pittsburgh, PA 15282, USA. martinr280@duq.eduengJ<7Bruening, D. A. Richards, J. G.2006?The effects of articulated figure skates on jump landing forces285-95J Appl Biomech224`*Acceleration Adolescent Adult Athletic Injuries/physiopathology/prevention & control Child Equipment Design Equipment Failure Analysis Female Humans Leg/*physiology Leg Injuries/physiopathology/prevention & control Male *Protective Clothing Range of Motion, Articular/physiology *Shoes Skating/injuries/*physiology *Sports Equipment Stress, MechanicalNovLower extremity injuries in figure skating have long been linked to skating boot stiffness, and recent increases in jump practice time may be influencing the frequency and seriousness of these injuries. It is hypothesized that stiff boots compromise skaters' abilities to attenuate jump landing forces. Decreasing boot stiffness by adding an articulation at the ankle may reduce the rate and magnitude of landing forces. Prototype articulated figure skating boots were tested in this study to determine their effectiveness in enabling skaters to land with lower peak impact forces. Nine competitive figure skaters, who trained in standard boots and subsequently in articulated boots, performed off-ice jump simulations and on-ice axels, double toe loops, and double axels. Analysis of the off-ice simulations showed decreases in peak heel force and loading rate with use of the articulated boot, although the exact kinematic mechanisms responsible for these decreases are still unclear. Analysis of the on-ice jumps revealed few kinematic differences between boot types, implying that the skaters did not use the articulation. Greater adaptation and training time is likely needed for the results seen off-ice to transfer to difficult on-ice jumps.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17293625 cComparative Study Evaluation Studies Journal Article Research Support, Non-U.S. Gov't United States1065-8483 (Print)Journal of applied biomechanics17293625LHuman Performance Laboratory, University of Delaware, Newark, DE 19716, USA.eng[<7)Brown, T. D. Varney, T. E. Micheli, L. J.2000ZMalleolar bursitis in figure skaters. Indications for operative and nonoperative treatment109-11Am J Sports Med281Adolescent Adult Ankle Joint/*pathology/surgery Bursitis/*etiology/pathology/surgery Female Humans Orthopedics/methods Pain/etiology Skating/*injuriesJan-FebFigure skaters are unique athletes who must train for extended periods of time performing motions and routines that create excessive compressive and shear forces between their malleoli and boots. As a result, they are susceptible to the development of a painful adventitious malleolar bursitis. Most often these patients will relate a recent increase in their training schedule or the purchase of a new pair of skating boots. This condition usually responds favorably to nonoperative measures including stretching of the boot over the affected area and protective padding placed around the inflamed bursa. If the swelling is marked, then an aspiration, subsequent injection with cortisone, and a compressive wrap may be indicated. This treatment regimen will enable the majority of figure skaters to continue skating. If the symptoms continue or increase despite nonoperative measures, then cessation of skating for a brief period must be considered. If this is not a viable option for the skater, surgical excision of the bursa may be warranted. If septic bursitis occurs, immediate surgical debridement and intravenous antibiotics are indicated. A Staphyloccocus aureus organism is most often responsible and should be treated with appropriate antibiotics. These patients may return to skating when there is no sign of further infection, the soft tissues have fully healed, and there is no sign of residual inflammatory bursa, usually at 4 to 6 weeks after surgery.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10653553 *Case Reports Journal Article United states0363-5465 (Print)'The American journal of sports medicine10653553SDivision of Sports Medicine, Children's Hospital, Boston, Massachusetts 02115, USA.eng<7 Bloch, R. M.1999Figure skating injuries 177-88, viiiPhys Med Rehabil Clin N Am101xAthletic Injuries/prevention & control/therapy Bone Density Female Humans Male Risk Factors Skating/*injuries/physiologyFebFigure skaters who train regularly sustain primarily lower extremity injuries, especially overuse injuries. Quadriceps and hamstring stretching may help prevent or decrease anterior knee pain. Foot and ankle problems may be related to the rigidity of the leather skating boot. The need for trunk strength to maintain body position is frequently under-emphasized. Air quality may also be a problem for those who skate in enclosed rinks.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10081059 $Journal Article Review United states1047-9651 (Print)=Physical medicine and rehabilitation clinics of North America10081059tDepartment of Physical Medicine and Rehabilitation, Tufts University School of Medicine, Boston, Massachusetts, USA.eng<7 Smith, A. D. Ludington, R.1989.Injuries in elite pair skaters and ice dancers482-8Am J Sports Med174Adolescent Adult Athletic Injuries/*epidemiology Child Craniocerebral Trauma/epidemiology Female Humans Leg Injuries/epidemiology Male Prospective Studies Risk Factors *Skating *Sports Thoracic Injuries/epidemiology United States Wrist Injuries/epidemiologyJul-Aug Figure skating coaches have become concerned about the increasing number of injuries among competitive skaters, particularly pair skaters. This study prospectively examines the incidence, severity, and cause of injuries sustained by a group of elite pair skaters and ice dancers. Thirty-three serious injuries, causing the skater to alter training significantly or to cease training completely for at least 7 consecutive days, were recorded over a 9 month period. Female senior pair skaters reported an average of 1.4 serious injuries, and other groups averaged greater than 0.5 serious injury per skater. The lower extremities were injured most frequently, and 7 of the 33 serious injuries were directly related to the skating boot. Eleven serious injuries were caused by lifts. Few of the serious injuries appeared preventable. Changes in boot design and the training for lifting maneuvers should be initiated and studied prospectively to attempt to reduce the unacceptably high injury rate among elite pair skaters and ice dancers.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2782532 Journal Article United states0363-5465 (Print)'The American journal of sports medicine2782532RDepartment of Medical Education, Alfred I. duPont Institute, Wilmington, DE 19899.eng u<7 #Bronner, S. Ojofeitimi, S. Rose, D.2008lRepair and rehabilitation of extensor hallucis longus and brevis tendon lacerations in a professional dancer362-70J Orthop Sports Phys Ther386Adult Dancing/*injuries Female Humans Metatarsophalangeal Joint/*injuries/surgery Muscle Strength Muscle, Skeletal/*injuries *Physical Therapy Modalities Range of Motion, Articular Tendon Injuries/*rehabilitation/surgeryJunRSTUDY DESIGN: Case report. BACKGROUND: Tendon lacerations of the hallux are potentially devastating to a dancer. Strength of the hallux musculature is necessary to attain and maintain balance, push-off in multiple turns, and decelerate in jumps and hops. The purpose of this paper is to report on the repair and rehabilitation of extensor hallucis longus and extensor hallucis brevis tendon lacerations in a professional dancer. CASE DESCRIPTION: A 30-year-old dancer sustained complete laceration of her extensor hallucis longus and extensor hallucis brevis tendons, and partial laceration of the dorsal aspect of the hallux metatarsophalangeal (MTP) joint capsule. Following primary repair, at 9 weeks postsurgery, hallux MTP joint active dorsiflexion was limited to 5 degrees and passive dorsiflexion to 70 degrees . First toe dorsiflexion and plantar flexion strength was 4/5 at the MTP and 3+/5 at the interphalangeal joint. Rehabilitation included functional electrical stimulation to address considerable calf atrophy, strengthening exercises, functional retraining, and progressive return to dance. OUTCOME: The dancer returned to her previous level of dancing in 18 weeks, with 73 degrees and 85 degrees of hallux MTP joint active and passive dorsiflexion, and 30 degrees and 35 degrees of active and passive plantar flexion, respectively. Hallux MTP and interphalangeal joint muscle strength were 5/5 and 4+/5, respectively. Improvement, manifested in her SF-36 and Dance Functional Outcome System scores, accompanied her full functional recovery. DISCUSSION: Hallux stability provided by coactivation of the great toe extensors and flexors is crucial to accomplish the demands of bipedal and unipedal balances and activities in dance. This report demonstrates the success of primary surgical repair and rehabilitation in a dancer/athlete experiencing this injury.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18515958 *Case Reports Journal Article United States0190-6011 (Print)6The Journal of orthopaedic and sports physical therapy18515958oAnalysis of Dance and Movement (ADAM) Center, Long Island University, Brooklyn, NY 11201, USA. sbronner@liu.edueng<7 "Bronner, S. Novella, T. Becica, L.2007;Management of a delayed-union sesamoid fracture in a dancer529-40J Orthop Sports Phys Ther379Adolescent Dancing/*injuries Female Fracture Healing/*physiology *Fractures, Bone Health Status Indicators Humans Sesamoid Bones/*injuries Time FactorsSep:BACKGROUND: Misdiagnosed o sesamoid bone pathology in dancers may result in prolonged pain, disability, and career limitation. A thorough understanding of sesamoid disorders and appropriate treatment facilitates timely recovery. The potential loss of hallux plantar flexion strength consequent to sesamoidectomy is a major consideration for dancers. CASE DESCRIPTION: An 18-year-old dance student sustained a delayed-union fracture of her lateral (fibular) sesamoid. Treatment included an inductive coupling external bone stimulator with pulsed electromagnetic field, activity, and weight-bearing restrictions, protective padding, strengthening, functional retraining, and progressive return to dance. OUTCOME: Following use of an external bone stimulator for 12 months, the dancer successfully returned to her previous level of dancing. Repeated SF-36 and Dance Functional Outcome System scores confirmed this improvement. DISCUSSION: Loss of hallux plantar flexion strength with sesamoid resection can be devastating to a dancer who requires push-off strength for multiple turns and jumps. Treatment with bone stimulation was therefore selected over more invasive measures. The dancer was compliant with systematic functional progression. Improvement, as seen on radiographs and outcome scores, accompanied her full functional recovery.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17939612 *Case Reports Journal Article United States0190-6011 (Print)6The Journal of orthopaedic and sports physical therapy17939612HADAM Center, Long Island University, Brooklyn, NY, USA. sbronner@liu.edueng1<7 0Meier, K. McPoil, T. G. Cornwall, M. W. Lyle, T.2008RUse of antipronation taping to determine foot orthoses prescription: a case series257-71Res Sports Med164$In order to determine if the use of antipronation taping could be used to direct foot orthoses prescription, seven high school athletes with lower extremity or foot pain caused by overuse stress were taped for 3 days during practice sessions. A visual pain scale and the Foot and Ankle Ability Measure sports subscale were used to monitor pain and function improvement caused by taping. If the taping was effective, foot orthotics were fabricated and posted according to the change in foot posture created by the tape. After wearing the foot orthotics for 4 weeks, all athletes reported a substantial short-term (4-week) reduction in pain and an increase in function. The results of this case series indicate that changes in foot posture created by taping can be used to guide foot orthosis prescription.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19089747 Journal Article United States1543-8635 (Electronic)#Research in sports medicine (Print)19089747qNorthern Arizona University, Department of Physical Therapy and Athletic Training, Flagstaff, Arizona 86011, USA.eng +<7 *Franettovich, M. Chapman, A. Vicenzino, B.2008iTape that increases medial longitudinal arch height also reduces leg muscle activity: a preliminary study593-600Med Sci Sports Exerc404,Adult Ankle/physiology *Bandages Electromyography Exercise Test Female Foot/*anatomy & histology/physiology Gait Humans Leg/anatomy & histology/*physiology Male Muscle Contraction/physiology Muscle, Skeletal/*physiology Pilot Projects *Posture Pronation/*physiology Walking/*physiology Weight-BearingAprPURPOSE:: To evaluate the initial effects of antipronation taping (APT) on foot posture and electromyographic (EMG) activity of tibialis anterior (TA), tibialis posterior (TP), and peroneus longus (PL) muscles during walking. METHODS:: Five asymptomatic individuals who exhibited lower medial longitudinal arch height on a clinical assessment of gait walked on a treadmill for 10 min before and after the application of an APT technique-specifically, the augmented low-Dye. Arch height (AH) in standing as well as peak and average amplitude, duration, time of onset, and time of offset of recorded EMG activity during walking were analyzed for each condition. RESULTS:: APT produced a mean (95% confidence interval (CI)) increase in AH of 12.9% (6.5-19.3; P = 0.005). Mean (95% CI) reductions in peak and average EMG activation of TA (peak: -23.9% (-34.0 to -13.9); average: -7.8% (-13.6 to -2.0)) and TP (peak: -45.5% (-77.3 to -13.7); average: -21.1% (-41.6 to -0.6)) were observed when walking with APT (P < 0.05). The APT also produced a small increase in duration of TA EMG activity of 3.7% (0.9-6.5) of the stride cycle duration, largely because of an earlier onset of EMG activity (4.4%; -8.1 to -0.8 of a stride cycle; P < 0.05). CONCLUSION:: APT reduces activity of the TA and TP muscles during walking while increasing AH, which provides preliminary evidence of its role in reducing the load of these key extrinsic muscles of the ankle and the foot. Follow-up study is required to evaluate these findings.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18317390 >Journal Article Research Support, Non-U.S. Gov't United States0195-9131 (Print)+Medicine and science in sports and exercise183173903Australian Institute of Sport, Canberra, AUSTRALIA.eng T<75Radford, J. A. Landorf, K. B. Buchbinder, R. Cook, C.2006eEffectiveness of low-Dye taping for the short-term treatment of plantar heel pain: a randomised trial64BMC Musculoskelet Disord7Adult *Bandages Fasciitis, Plantar/physiopathology/*therapy Humans Middle Aged Pain Measurement/methods Podiatry/*methods Questionnaires Single-Blind Method:BACKGROUND: Plantar heel pain is one of the most common musculoskeletal disorders of the foot and ankle. Treatment of the condition is usually conservative, however the effectiveness of many treatments frequently used in clinical practice, including supportive taping of the foot, has not been established. We performed a participant-blinded randomised trial to assess the effectiveness of low-Dye taping, a commonly used short-term treatment for plantar heel pain. METHODS: Ninety-two participants with plantar heel pain (mean age 50 +/- 14 years; mean body mass index 30 +/- 6; and median self-reported duration of symptoms 10 months, range of 2 to 240 months) were recruited from the general public between February and June 2005. Participants were randomly allocated to (i) low-Dye taping and sham ultrasound or (ii) sham ultrasound alone. The duration of follow-up for each participant was one week. No participants were lost to follow-up. Outcome measures included 'first-step' pain (measured on a 100 mm Visual Analogue Scale) and the Foot Health Status Questionnaire domains of foot pain, foot function and general foot health. RESULTS: Participants treated with low-Dye taping reported a small improvement in 'first-step' pain after one week of treatment compared to those who did not receive taping. The estimate of effect on 'first-step' pain favoured the low-Dye tape (ANCOVA adjusted mean difference -12.3 mm; 95% CI -22.4 to -2.2; P = 0.017). There were no other statistically significant differences between groups. Thirteen participants in the taping group experienced an adverse event however most were mild to moderate and short-lived. CONCLUSION: When used for the short-term treatment of plantar heel pain, low-Dye taping provides a small improvement in 'first-step' pain compared with a sham intervention after a one-week period.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16895612 TJournal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't England1471-2474 (Electronic)BMC musculoskeletal disorders16895612School of Biomedical and Health Sciences, University of Western Sydney, Locked Bag 1797, Penrith South DC, NSW, 1797, Australia. j.radford@uws.edu.aueng ,<76Wilkerson, G. B. Kovaleski, J. E. Meyer, M. Stawiz, C.2005bEffects of the subtalar sling ankle taping technique on combined talocrural-subtalar joint motions239-46Foot Ankle Int263Adult Ankle/*physiology Ankle Injuries/prevention & control *Bandages Female Foot Joints/*physiology Humans Male Range of Motion, Articular Restraint, Physical/methods Subtalar Joint/*physiologyMarBACKGROUND: The findings of research on the effectiveness of ankle taping for protection against ligament injury have been inconsistent, and the topic remains controversial. The precise orientation of the force vectors created by tension within the various tape strip components of an ankle taping procedure may be a critical factor influencing the degree of motion restraint that is provided. We hypothesized that the addition of the subtalar sling component to the widely recognized standard (Gibney) ankle taping procedure would enhance restraint of ankle motion. This was a controlled laboratory study, with fully repeated measures (subjects served as their own controls). METHODS: An ankle arthrometer was used to quantify anteroposterior (AP) translation and frontal plane inversion-eversion (I-E) tilt of the talocrural-subtalar joints under untaped and taped conditions in normal subjects. A 15-minute exercise session was conducted to loosen the tape before measurement of its effect on motion restraint. RESULTS: The ankle taping procedure that incorporated the subtalar sling provided significantly greater restriction of postexercise AP translation (p < 0.001, eta(2) = 0.63) and postexercise I-E tilt (p < 0.001, eta(2) = 0.66). CONCLUSIONS: The subtalar sling ankle taping procedure provides greater restriction of motions associated with ankle instability than the more widely used Gibney procedure.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15766428 ZClinical Trial Comparative Study Journal Article Randomized Controlled Trial United States1071-1007 (Print)kFoot & ankle international / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society15766428Graduate Athletic Training Program, University of Tennessee at Chattanooga, 615 McCallie Avenue, Department 6606, Chattanooga, TN 37403-2598, USA. Gary-Wilkerson@utc.edueng>7Wilkerson, G. B.2002CBiomechanical and Neuromuscular Effects of Ankle Taping and Bracing436-445 J Athl Train374DecdOBJECTIVE: An extensive review of clinically relevant research is provided to assist clinicians in understanding the underlying mechanisms by which various ankle-support systems may provide beneficial effects. Strategies for management of different types of ankle ligament conditions are also discussed. BACKGROUND: Much of the literature pertaining to ankle instability and external support has focused on assessment of inward displacement of the hindfoot within the frontal plane. Some researchers have emphasized the importance of (1) pathologic rotary displacement of the talus within the transverse plane, (2) the frequent presence of subtalar joint ligament lesions, and (3) the interrelated effects of ankle support on deceleration of inversion velocity and facilitation of neuromuscular response. DESCRIPTION: The traditional method for application of adhesive tape to the ankle primarily restricts inward displacement of the hindfoot within the frontal plane. The biomechanical rationale for a method of ankle taping that restricts lower leg rotation and triplanar displacement of the foot associated with subtalar motion is presented. CLINICAL ADVANTAGES: The lateral subtalar-sling taping procedure may limit strain on the anterior talofibular ligament associated with subtalar inversion, restrain anterolateral rotary subluxation of the talus in the presence of ligament laxity, and protect the subtalar ligaments from excessive loading. The medial subtalar sling may reduce strain on the anterior-inferior tibiofibular syndesmosis and enhance hindfoot-to-forefoot force transfer during the push-off phase of the gait cycle.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12937565 Journal articleJournal of athletic training12937565<The University of Tennessee at Chattanooga, Chattanooga, TN.Eng <7Meyer, J. Kulig, K. Landel, R.2002MDifferential diagnosis and treatment of subcalcaneal heel pain: a case report114-22; discussion 122-4J Orthop Sports Phys Ther323Adult Diagnosis, Differential *Heel Humans Male Pain/*etiology *Physical Therapy Modalities Tibial Neuropathy/*diagnosis/*therapyMarOBJECTIVE: To describe the examination and intervention strategy utilized in the differential diagnosis and treatment of a patient with subcalcaneal heel pain. BACKGROUND: The patient was a 44-year-old man with an 8-month history of left subcalcaneal heel pain. He presented with a chief complaint of limited standing and walking tolerance secondary to pain in the left heel. He had not responded to previous treatments of rest, anti-inflammatory medication, cortisone injections, and exercise prescription. MATERIALS AND METHODS: The patient's subcalcaneal heel pain was reproduced utilizing the straight leg raise (SLR) in combination with ankle dorsiflexion and eversion to sensitize the tibial nerve. These findings suggested a neurogenic component to the dysfunction. Because restricted ankle dorsiflexion, excessive pronation, and posterior tibialis weakness were also found, mechanical dysfunctions also likely contributed to the etiology of heel pain. The patient was treated for 10 visits over a period of 1 month. Treatment consisted of active and passive motions aimed at restoring pain-free soft-tissue motion along the course of the tibial nerve. In addition, low-dye taping and therapeutic exercises were utilized to control excessive pronation and reduce stress on the plantar structures of the foot. RESULTS: The patient's SLR increased from 42 degrees to 54 degrees and became pain-free. Dorsiflexion range of motion increased from 3 degrees to 8 degrees in the left ankle, and left posterior tibialis strength was normalized. Over a period of 1 month the patient's symptoms were resolved, and his standing and walking tolerance was fully restored. CONCLUSION: Assessment and potential contribution of neural dysfunction should be considered in patients with subcalcaneal heel pain.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12168738 *Case Reports Journal Article United States0190-6011 (Print)6The Journal of orthopaedic and sports physical therapy12168738CHarbor Physical Therapy, San Pedro, CA 90732, USA. jmpt@bigfoot.comeng <7(Holmes, C. F. Wilcox, D. Fletcher, J. P.2002Effect of a modified, low-dye medial longitudinal arch taping procedure on the subtalar joint neutral position before and after light exercise194-201J Orthop Sports Phys Ther325Adult Bandages Biomechanics Female Humans Joint Instability/*prevention & control Male Middle Aged Orthopedic Procedures/*methods Subtalar Joint/*physiology Walking/*physiologyMay STUDY DESIGN: Single-group repeated measures design pre- and postintervention. OBJECTIVES: To determine if the modified low-Dye medial longitudinal arch (MLA) taping procedure places the subtalar joint into the neutral position and maintains the subtalar joint neutral (STJN) position following 10 minutes of walking. BACKGROUND: Subtalar malalignment in excessive pronation is commonly accepted as a contributing factor to a variety of musculoskeletal pathologies. The modified low-Dye MLA taping procedure is often used on the plantar surface of the foot as a short-term corrective tool for excessive foot pronation. However, research that evaluates the efficacy of this taping technique during light exercise is lacking. Measurement of navicular height is commonly used as a measure of subtalar position. METHODS AND MEASURES: Prior to the study, one tester-established reliability in the navicular drop technique measurement by initially practicing the measurements on 400 feet, followed by a reliability study performed on 29 subjects. In this study, a screening procedure excluded subjects with ankle or foot pathology, supinated feet, or neutral feet, and included only subjects with pronated feet. The study, which included 40 subjects, involved four steps: (1) measuring navicular height in the relaxed position; (2) measuring navicular height in the STJN position; (3) measuring navicular height after application of the modified low-Dye MLA taping procedure; and (4) measuring navicular height after subjects had walked for 10 minutes with the taping. RESULTS: Results indicated an intrarater intraclass correlation coefficient (ICC) for measuring navicular height of 0.96 for the right foot and 0.94 for the left foot. Repeated measures ANOVA revealed that significant differences existed (P < 0.05) among the 4 measures. A Bonferroni post hoc analysis showed a difference between relaxed stance measurements and all other measurements, and between taped-prewalking measurements and taped-postwalking measurements. In addition, no significant difference was observed between navicular height measured in STJN and the taped-prewalking and taped-postwalking conditions. The average navicular height for the taped-prewalking condition was 1.6 mm higher than that for the STJN position. For the taped-postwalking condition, the average height of the navicular was 1.2 mm lower than that of the STJN position. CONCLUSION: These results demonstrate that the modified low-Dye MLA taping procedure places the subtalar joint near the neutral position. Despite a significant reduction in the height of the navicular after the subjects walked for 10 minutes with the tape on, the height of the navicular was still not significantly different than that of the STJN position.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12014823 ,Clinical Trial Journal Article United States0190-6011 (Print)6The Journal of orthopaedic and sports physical therapy12014823lDepartment of Physical Therapy, University of Central Arkansas, Conway 72035-0001, USA. holmesc@mail.uca.edueng<7Keenan, A. M. Tanner, C. M.2001<The effect of high-Dye and low-Dye taping on rearfoot motion255-61J Am Podiatr Med Assoc915Ankle Australia *Bandages Female Foot/*physiology Heel/*physiology Humans Leg Male *Motion Podiatry/*methods Pronation Walking/physiologyMayuHigh-Dye and low-Dye taping are commonly used by clinicians to treat a variety of foot and ankle pathologies, particularly those associated with excessive rearfoot pronation. While the effects of taping on end range of motion have been extensively studied, relatively little is understood about the effect of the two styles of taping on rearfoot motion. Eighteen participants were analyzed in three conditions: 1) barefoot, 2) with high-Dye taping, and 3) with low-Dye taping. Two-dimensional motion of the rearfoot was assessed for each condition. The results indicated maximum inversion was increased with both high-Dye and low-Dye taping as compared with no taping. Only high-Dye taping, however, significantly reduced the maximum eversion of the rearfoot. The results suggest that high-Dye taping is an appropriate taping choice when control of eversion of the rearfoot is desired.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11359891 ,Clinical Trial Journal Article United States8750-7315 (Print)5Journal of the American Podiatric Medical Association11359891XAustralian Faculty of Public Health Medicine, La Trobe University, Melbourne, Australia.eng<72Nishikawa, T. Kurosaka, M. Mizuno, K. Grabiner, M.20003Protection and performance effects of ankle bracing285-8 Int Orthop245Adult *Ankle/physiology Biomechanics *Braces Female Humans Ligaments, Articular/physiology Male Movement/physiology Muscle, Skeletal/*physiologyWe investigated the protection afforded to ankle ligaments by ankle supports and the extent to which these were associated with a diminution of motor performance. Eleven volunteers were subjected to a 10 degrees tilt in four directions (inversion, eversion, plantar flexion and dorsiflexion) on a rocking platform. Three-dimensional videography was used to record complex ankle kinematics. The prophylactic ankle supports used were a semi-rigid brace, a lace-up cloth brace, and taping. The ankle supports provided similar initial protection against acute ligamentous inversion sprains. The semi-rigid ankle brace produced a smaller restriction of plantar flexion-dorsiflexion movement than either the lace-up cloth brace or taping.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11153461 8Journal Article Research Support, Non-U.S. Gov't Germany0341-2695 (Print)International orthopaedics11153461Department of Orthopaedic Surgery, Kobe University School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017, Japan. nishikaw@med.kobe-u.ac.jpeng <7*Requejo, S. M. Kulig, K. Thordarson, D. B.2000^Management of foot pain associated with accessory bones of the foot: two clinical case reports580-91; discussion 592-4J Orthop Sports Phys Ther3010}Adult Diagnosis, Differential Female Foot Diseases/diagnosis/rehabilitation/*therapy *Fractures, Bone/complications/therapy Humans Male Middle Aged Neuritis/complications Orthotic Devices Pain/etiology/rehabilitation/*therapy Pain Measurement Physical Therapy Modalities Sesamoid Bones/*abnormalities/*injuries Sural Nerve Tarsal Bones/*abnormalities/*injuries/surgery Time FactorsOct STUDY DESIGN: Case study. OBJECTIVES: To discuss the differential diagnosis, the nonsurgical and postoperative management of common accessory bones of the foot. BACKGROUND: Accessory bones of the foot that are formed during abnormal ossification are commonly found in asymptomatic feet. Two of the most common accessory bones are the accessory navicular and the os peroneum. Their painful presence must be considered in the differential diagnosis of any acute or chronic foot pain. The optimal treatment for the conservative and postoperative management of painful os peroneum and accessory navicular bones remains undefined. METHODS AND MEASURES: Therapeutic management of the fractured os peroneum included bracing, taping, and foot orthotics to allow healing of involved tissues, and stretching. The focus of the postoperative management of the accessory navicular was joint mobilization and progressive strengthening. Dependent variables included level of pain with provocation and alleviation tests of joint and soft tissue; girth and sensory tests of the foot and ankle; goniometric measures of foot and ankle; strength of ankle and hip muscles; functional tests; and patient's self-reported pain status. RESULTS: The patient with the fractured os peroneum was treated in 13 visits for 10 weeks. At discharge from physical therapy, the patient had the following outcomes relative to the noninvolved side: 100% return of normal sensation tested by light touch and vibration; pain decreased from 6/10 to 1/10; 100% reduction of swelling with ankle girth to normal; 100% range of motion of ankle and subtalar joints. Strength in plantar flexion and eversion remained 20% impaired (80% return to normal) secondary to pain. Upon discharge, he still reported mild pain when walking but was able to return to previous leisure activities. The second patient with the accessory navicular was treated in 18 visits over 9 weeks. Relative to the uninvolved side, she was discharged with the following: 70% return of range of motion in the foot and ankle, 100% of strength in hip and ankle, and 100% return of balance. She could squat and jump without pain and she returned to full premorbid activity level. CONCLUSIONS: Rehabilitative management of both cases addressed specific impairments and was successful in improving the patients' activity limitation. Clinicians should be aware that these accessory bones are possible sources of disability, secondary to foot pain.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11041195 <Case Reports Comparative Study Journal Article United states0190-6011 (Print)6The Journal of orthopaedic and sports physical therapy11041195yDepartment of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, USA. smais@msmc.la.edueng?+Berglund, C.L. Philips, L.E. Ojofeitimi, S.2006$Flexor hallucis longus among dancers26-31%Orthopaedic Physical Therapy Practice183~?(Aper, R. L. Saltzman, C. L. Brown, T. D.1994]The effect of hallux sesamoid resection on the effective moment of the flexor hallucis brevis462-70Foot Ankle Int159Biomechanics Cadaver Comparative Study Foot/*physiology Hallux/anatomy & histology/*surgery Humans Models, Theoretical Muscle Fibers/physiology Tendons/*physiologySep;In this cadaver study, the functional significance of the hallux sesamoid bones was quantified by measuring the effective tendon moment arm (ETMA) of the flexor hallucis brevis (FHB) force. (The ETMA differs from the anatomic tendon moment arm in that ETMAs are determined by the experimentally measured moment of the tendon force, rather than by the actual location and orientation of the tendon pull in the joint). The intact case was compared with three levels of progressive sesamoid resection: distal half of the medial sesamoid excised, entire medial sesamoid excised, and both the medial and lateral sesamoids excised. Five dorsiflexion angles of the metatarsophalangeal joint were tested, ranging from -10 degrees to 50 degrees. A known active load was applied to the FHB muscle of fresh frozen cadaver specimens while the corresponding resisting forces from three orthogonally mounted transducers were being recorded. Results showed that the ETMAs decreased significantly (P < .05) only with the excision of both sesamoids. The percent decrease in ETMA was smallest at dorsiflexion angles of -10 degrees and 15 degrees (4.3% and 2.4%, respectively) and largest at dorsiflexion angles of 25 degrees, 35 degrees, and 50 degrees (29.2%, 22.4%, and 26.7%, respectively). The clinical significance of the results is that distal hemiresection of the medial sesamoid or full medial sesamoid excision is unlikely to appreciably compromise the effective mechanical advantage of the FHB muscle. However, this mechanical advantage may be profoundly diminished by excision of both hallux sesamoids.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7820237 !1071-1007 (Print) Journal Article7820237GDepartment of Orthopaedic Surgery, University of Iowa, Iowa City 52242.~?(Aper, R. L. Saltzman, C. L. Brown, T. D.1996OThe effect of hallux sesamoid excision on the flexor hallucis longus moment arm209-17Clin Orthop Relat Res325-Biomechanics Cadaver Chronic Disease Hallux/*physiopathology Humans Metatarsophalangeal Joint/*physiopathology Osteotomy/*adverse effects/*methods Pain/physiopathology/surgery *Range of Motion, Articular Research Support, Non-U.S. Gov't Sesamoid Bones/*surgery Tendons, Para-Articular/*physiopathologyApr/Surgical treatments for chronic, painful hallux sesamoid disorders typically involve partial or complete resection of 1 or both sesamoids. Although these approaches generally result in satisfactory symptom relief, their effect on biomechanical function of the major hallux flexors is not completely understood. The effects of selective sesamoid resections on the effective tendon moment arm of the flexor hallucis longus tendon were evaluated. Twelve fresh frozen cadaver first rays were each mounted in a device that held rigid the metatarsal. A ramp-controlled displacement of an MTS ram supplied a functional load input force to the flexor hallucis longus. The components of the resultant output force necessary to resist the input flexor hallucis longus force were transduced simultaneously by a multicomponent load cell. Subsequently, 3 progressively more extensive seasamoid resections were done: (1) distal hemiresection, (2) complete resection, and (3) resection of both sesamoids. Six specimens were tested with the medial sesamoid removed first and 6 with the lateral sesamoid removed first. Statistical analysis showed that significant decreases in the effective tendon moment arms occurred with full medial sesamoid resection, full lateral sesamoid resection, and resection of both the medial and lateral sesamoids.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8998878 !0009-921X (Print) Journal Article8998878LDepartment of Orthopaedic Surgery, University of Iowa, Iowa City 52242, USA.<7Jennings, J. Davies, G. J.2005NTreatment of cuboid syndrome secondary to lateral ankle sprains: a case series409-15J Orthop Sports Phys Ther357Adolescent Adult Ankle Injuries/diagnosis/*rehabilitation Athletic Injuries/diagnosis/*rehabilitation Diagnosis, Differential Female Humans Male Manipulation, Orthopedic Pain Measurement Palpation Sprains and Strains/diagnosis/*rehabilitation SyndromeJulSTUDY DESIGN: Case series. BACKGROUND: Plantar flexion/inversion ankle sprains are one of the most frequently occurring sports injuries. Cuboid syndrome, which is difficult to diagnose, may result from a plantar flexion/ inversion ankle injury and could become the source of lateral ankle/midfoot pain. The objective of this case series is to describe the examination, evaluation, and treatment of the cuboid syndrome following a lateral ankle sprain. CASE DESCRIPTION: Seven patients were seen in our clinic 1 to 8 weeks following a lateral ankle sprain with a chief complaint of lateral ankle/midfoot pain. In these 7 patients, the presence of cuboid syndrome was identified independently by 2 examiners. Treatment consisted of a cuboid manipulation. OUTCOMES: All 7 patients returned to sports activities following 1 to 2 treatments consisting of the "cuboid whip" manipulation. No recurrence of symptoms was reported upon immediate return to competition or during the remainder of the season (mean follow-up, 5.7 months; range, 2 to 8 months). DISCUSSION: Based on those 7 patients, our results suggest that patients who are properly diagnosed with cuboid syndrome and receive the cuboid manipulation can return to competitive activity within 1 or 2 visits without injury recurrence.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16108581 Journal Article United States0190-6011 (Print)6The Journal of orthopaedic and sports physical therapy16108581MGundersen Lutheran Sports Medicine, Onalaska, WI, USA. jmjennings13@yahoo.comeng +<7+Kolettis, G. J. Micheli, L. J. Klein, J. D.1996>Release of the flexor hallucis longus tendon in ballet dancers1386-90J Bone Joint Surg Am789Adolescent Adult Ankle/physiopathology/*surgery Constriction, Pathologic/etiology/physiopathology/rehabilitation/surgery *Dancing/injuries Female Follow-Up Studies Foot/*surgery Humans Methods Pain/physiopathology Physical Therapy Modalities Postoperative Care Retrospective Studies Subtalar Joint/physiopathology Tendons/physiopathology/*surgery Tenosynovitis/etiology/physiopathology/rehabilitation/*surgery Treatment Outcome Weight-BearingSepThirteen female ballet dancers had an operative release of the flexor hallucis longus tendon because of isolated stenosing tenosynovitis, and the results were reviewed after a mean duration of follow-up of six years and six months (range, two to ten years). All of the patients danced at the advanced or professional level, and all had failed to respond to non-operative management. The mean age of the patients at the time of the operation was twenty years (range, thirteen to twenty-six years). Symptoms, which included pain and tenderness over the medial aspect of the subtalar joint, had been present for a mean of six months (range, two to twelve months) preoperatively and were exacerbated by jumping and by attempts to perform en pointe work. Crepitus was present in six patients, and triggering was present in three. No patient had evidence of a symptomatic os trigonum. Postoperatively, all patients participated in a formal physical-therapy program for a mean of nine weeks (range, four to thirteen weeks). All patients returned to dancing, within a mean of five months (range, two to nine months), and eleven reached a level of full participation in dancing without restriction. At the time of the most recent follow-up, all patients noted improvement compared with the pre-operative condition. Eight patients were professional ballet dancers, four were students at advanced ballet schools, and one had stopped performing ballet for reasons unrelated to the tenosynovitis of the flexor hallucis longus. In addition, two of the students had decided not to pursue careers in dancing because of persistent, but greatly diminished, symptoms. No complications were noted in this series. We concluded that an operative release of the flexor hallucis longus is effective for the treatment of isolated stenosing tenosynovitis in female ballet dancers who place high demands on the foot and ankle and for whom non-operative treatment has failed.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8816655 /Comparative Study Journal Article United states0021-9355 (Print)%The Journal of bone and joint surgery88166556Children's hospital, Boston, Massachusetts 02115, USA.eng<7Marshall, P. Hamilton, W. G.1992$Cuboid subluxation in ballet dancers169-75Am J Sports Med202Adult Dancing/*injuries *Dislocations/diagnosis/etiology/rehabilitation Female Humans Male Metatarsal Bones/*injuries Physical Therapy ModalitiesMar-AprCuboid subluxation is a common but poorly recognized condition. Its symptoms include lateral midfoot pain and an inability to "work through the foot." In addition, pressing on the plantar surface of the cuboid in a dorsal direction produces pain. The normal dorsal/plantar joint play is reduced or absent when compared to the uninjured side, and subtle forefoot valgus is present. Frequently, there is a shallow depression on the dorsal surface of the foot and palpable fullness on the plantar aspect of the cuboid. Documentation by radiograph, CT scan, or magnetic resonance imaging is difficult because of the normal variations found in the relationship between the cuboid and its surrounding structures. The diagnosis is primarily subjective, and must be made on the basis of the patient's history and physical findings. Treatment requires recognition of the condition, manual reduction by a therapist or physician familiar with the condition, and follow-up to be certain that the cuboid remains in place. Therapists and orthopaedists involved in the care of dancers should be alert to the possibility of cuboid subluxation and be able to recognize it when it occurs.ehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1558245 *Case Reports Journal Article United states0363-5465 (Print)'The American journal of sports medicine1558245,American Ballet Theater, New York, New York.eng ?5Bronner, S. Spriggs, J. Ojofeitimi, S. Brownstein, B.2003FOutcomes measures in healthy and injured elite dancers: DFOS and SF-36A24 (Abstract)J Orthop Sports Phys Ther332> PURPOSE: Professional dancers sustain injuries at alarming rates, with 57-72% new lower extremity injuries in any given year. Dance medicine has no dance-specific functional outcome tools to study efficacy of medical interventions or to determine performance readiness as a discharge criterion. The Dance Functional Outcome System (DFOS) was developed for use with ballet and modern dancers of all training levels following lower extremity injury. The purpose of this study was to assess reliability and sensitivity to change of the DFOS and a generic health measure, the SF-36, in professional dancers. SUBJECTS: 1) 12 physical therapists, athletic trainers, and dance research assistants participated in reliability testing of scoring the DFOS Part II. 2) 53 healthy professional dancers participated in one time DFOS and SF-36 testing. 3) 21 of these dancers participated in repeated testing of the DFOS and SF-36. METHODS: 1) A videotape of two dancers was used to train and test examiners in scoring the DFOS Part II. 2) All healthy subjects completed the DFOS and SF-36 once 3) 21 dancers, 14 dancers who sustained no injuries and 7 who sustained lower extremity injury, participated in repeated testing of the DFOS and SF-36. ANALYSIS: 1) Pearson correlations were calculated for intra- and inter-tester reliability of scoring the DFOS Part II. 2) Means (SD) for the 53 healthy dancers were calculated for the DFOS and SF-36 as a normative baseline. 3) Healthy and injured subjects were compared using repeated measures ANOVA (P<0.05). RESULTS: 1) Intra- and inter-tester correlations ranged from r=.90-.99 (P<0.01) for scoring the two subjects in the DFOS Part II. 2) The 53 healthy dancers scored 94 (±1.84) in the DFOS Part I, and 99 (±0.19) bilaterally, 98 (±1.51) left, and 99 (±0.71) right in the DFOS Part II. In the SF-36, the dancers scored 57.20 (±5.75) in the Physical Summary and 36.24 (±7.90) in the Mental Health Summary scores. 3) 14 healthy dancers and 7 injured dancers were compared over two times: Time 0 (prospective healthy baseline) and Time 1 (following injury for the injured group). There were significant differ-ences for Time and Time * Group (P<0.01) in the DFOS Part I and II, and in the SF-36 Physical Summary and three of the four Physical component scores. Injured subjects, measured at four time periods, revealed a significant quadratic trend (P<0.01) in the DFOS Part I, SF-36 Physical Summary, and three Physical component scores (P<0.01). CONCLUSION: Preliminary analysis of the DFOS and SF-36 suggests that these instruments are responsive to musculoskeletal injury and recovery in the elite dance population. Inclusion of a generic health measure such as the SF-36, provides additional insight into the effect of musculoskeletal injury on well being in this population. RELEVANCE: The DFOS may be useful for dance researchers to compare various treatments for dance injury as well as serve as a measurement tool for treatment efficacy. Further study of the sensitivity, specificity, and validity of the DFOS, in conjunc-tion with the SF-36, in injured dancers is now underway. H?Bronner, S. Turner, R.1999BThe Dance Functional Outcome System (DFOS): A new measurement toolA-20 (abstract) J Orthop Sports Phys Ther291 PURPOSE: Dancers are elite artist-athletes with unique functional requirements. The specialty of dance medicine has no dance-specific functional outcome standardized tools to study efficacy and effectiveness of medical interventions or to determine performance readiness as a discharge criteria. The Dance Functional Outcome System (DFOS) was developed to be used with ballet and modern dancers of all training levels, with any type of injury to the lower extremity or lumbar spine. The DFOS is comprised of four sections: 1) clinical impairment measures, 2) patient subjective questionnaire, 3) quantitative performance measure, and 4) work/dance activity status. Each section is scored separately and can be used alone. This study determined content validity, reliability, criterion and concurrent validity, and construct validity of sections two through four in healthy dancers. SUBJECTS: Experts in the areas of dance medicine (orthopaedists and physical therapists), dance education and research, and elite dancers reviewed the DFOS for content validity. Forty healthy ballet and modern dancers of all ages (15-40) and skill levels (beginning to professional) volunteered for this study. METHODS: All healthy subjects completed the DFOS twice within a one week period to determine reliability. During one session, subjects were also asked to complete other validated functional rating scales (ie Oswestry Low Back Pain Questionnaire, modified Noyes Knee Rating Scale) for criterion validity. ANALYSIS: The intraclass correlation coefficient was calculated for intra and intertester reliability for each portion of the DFOS. Means and SD for groups by training level, training style, and age group were compared with repeated measures ANOVA (p<0.05). RESULTS: The development and revision of the DFOS following content review are described. Intra and intertester, and repeated measures reliability will be presented. Criterion, concurrent, and construct validity are reviewed. CONCLUSION: The DFOS warrants additional study on injured dance populations to determine sensitivity and specificity. It requires little to no examiner training, and is relatively user friendly. RELEVANCE: The objective of the DFOS is to ascertain functional status as it relates to ability to dance/work, length of time since injury, and premorbid status. The DFOS can be used as a screening and injury management tool to determine performance readiness as a discharge criteria. We hope this DFOS will enable dance researchers to compare various treatments for dance injury as well as serve as a measurement tool for treatment efficacy. Further study of the sensitivity and specificity of the DFOS in injured dancers is now underway.F<76Albisetti, W. Ometti, M. Pascale, V. De Bartolomeo, O.2008EClinical Evaluation and Treatment of Posterior Impingement in DancersAm J Phys Med RehabilJul 9qOs trigonum impingement is a frequent cause of posterior ankle pain in ballet dancers because they need extreme plantar flexion during the execution of releve in demipointe and en pointe positions. Clinical examination and standard and modified x-rays should be carried out to clearly identify the site and entity of the impingement. If a posterior impingement is clinically diagnosed, standard and modified magnetic resonance imaging should be also performed. From September 2005 to September 2006, we considered 186 young trainee ballet dancers. Twelve suffered from posterior ankle pain, and six of these had os trigona. We treated all the ballet dancers nonoperatively, and nine of them had good results. Conservative treatment failed in only three cases after 1-4 mos of physical and medical therapies, and, in these cases, good results were obtained through surgical excision of the accessory ossicle. Modified x-ray and magnetic resonance imaging help to determine the site and entity of the posterior impingement. If this is properly diagnosed, good results can be obtained through a nonoperative approach in a majority of cases.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18617858 Journal article1537-7385 (Electronic)]American journal of physical medicine & rehabilitation / Association of Academic Physiatrists18617858From the University of Milan, Milan, Italy (WA, MO, ODB); Teatro Alla Scala Ballet Company, Milan, Italy (WA); Gaetano Pini Hospital, Milan, Italy (WA, MO, ODB); and IRRCS R Galeazzi Institute for Treatment and Research, Milan, Italy (VP).EngF~?-Eils, E. Imberge, S. Volker, K. Rosenbaum, D.2006dPassive Stability Characteristics of Ankle Braces and Tape in Simulated Barefoot and Shod ConditionsAm J Sports MedNov 7BACKGROUND: Ankle sprains are among the most common injuries in barefoot sport activities such as dance, gymnastics, or trampoline. At present, the use of external ankle devices for prevention of ligament injuries for barefoot activities remains unclear. HYPOTHESIS: External ankle devices have a significant loss of passive stability when used without a shoe in barefoot activities. STUDY DESIGN: Controlled laboratory study. METHODS: Twenty-five healthy subjects participated in the project (mean age, 26.2 +/- 3.3 years; mean body mass, 71.2 +/- 10.3 kg; mean height, 178 +/- 7 cm). Passive range of motion measurements were performed with 3 different ankle stabilizers (a stirrup brace, a lace-up brace, and tape), as well as 2 different shoe conditions (cutout shoe [simulated barefoot] and normal shoe). RESULTS: In the simulated barefoot condition, a significantly reduced stabilizing effect for inversion and eversion (19% and 29%, respectively) was found for the stirrup ankle brace. Small decreases were noted with the soft brace and tape, but these were not statistically significant. CONCLUSION: The passive stability characteristics of ankle braces depend to a great extent on being used in combination with a shoe. This is especially true for semirigid braces with stirrup design. Therefore, it is recommended that soft braces (like the one tested in the present investigation) be used in barefoot sports for restricting passive range of motion of the foot and ankle complex. CLINICAL RELEVANCE: This study provides useful information for clinicians to select or recommend an external ankle stabilizing device in barefoot sports to restrict passive range of motion of the foot-ankle complex most effectively.fhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17092922 !0363-5465 (Print) Journal article17092922Funktionsbereich Bewegungsanalytik (Movement Analysis Lab Orthopaedic Department, University Hospital Munster, Munster, Germany.PK0:I/**refs.FRM 0B< !// !HPRIMARYyearIndex 6ByP/) idreference_type text_stylesauthoryear title pages secondary_title volume numbernumber_of_volumessecondary_authorplace_published publishersubsidiary_authoredition keywords type_of_workdate2)  abstractlabelurltertiary_titletertiary_author notes isbn custom_1 custom_2 custom_3 custom_4alternate_titleaccession_number call_number short_title custom_5 custom_6sectionoriginal_publicationH) reprint_editionreviewed_itemauthor_addressimagecaption custom_7 electronic_resource_number link_to_pdf translated_author translated_titlename_of_databasedatabase_providerresearch_notes language access_datelast_modified_date !! 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