Study design, case-control study: Background, Morton’s extension (ME) is a kind of orthotic that has been used as a conservative treatment of painful hallux rigidus (HR) osteoarthritis, but only their effects on first metatarsophalangeal joint (MPJ) mobility and position in healthy subjects have been studied, but not on its applied pulled tension forces neither in subjects with HR. Objectives: This study sought to understand how ME’s orthotics with three different thicknesses could influence the kinematic first MPJ by measuring hallux dorsiflexion using Jack’s test and a digital algometer with a rigid strip anchored to the iron hook’s extremity and comparing subjects with healthy first MPJ mobility to those with HR. We aimed to clarify whether tension values were different between healthy and HR subjects. Methods: Fifty-eight subjects were selected, of whom thirty were included in the case group according to HR criteria and twenty-eight were included in the control group. A digital algometer (FPX^®® 25, Wagner Instruments^®®, Greenwich, CT, USA) was used to assess the pulled tension values (kgf) of the first MPJ during Jack’s test. Results: The pulled tension values were highly reliable (ICC > 0.963). There were no statistically significant differences between the pulled tension values for the different ME conditions in the case (p = 0.969) or control (p = 0.718) groups. However, as it’s expected, there were statistically significant differences comparing all pulled tension values between case and control group subjects (p < 0.001). Conclusions: Different ME’s thicknesses had no influence on the pulled effort applied during the dorsiflexion Jack’s test between the healthy and HR groups; therefore, it can be prescribed without joint-care danger. In addition, it is proven that there is greater resistance to performing Jack’s test in the HR group than in the healthy group, regardless of ME’s orthotics. Furthermore, it is shown that the digital algometer device is a valid tool to detect the first MPJ restriction and is more reliable than other tests.

Background: The mobility of the first metatarsophalangeal joint (I MPTJ) has been related to the proper windlass mechanism and the triceps surae during the heel-off phase of running gait; the orthopedic treatment of the I MPTJ restriction has been made with typical Morton extension orthoses (TMEO). Nowadays it is unclear what effects TMEO or the novel inverted rocker orthoses (NIRO) have on the EMG activity of triceps surae during running. Objective: To compare the TMEO effects versus NIRO on EMG triceps surae on medialis and lateralis gastrocnemius activity during running. Study design: A cross-sectional pilot study. Methods: 21 healthy, recreational runners were enrolled in the present research (mean age 31.41 ± 4.33) to run on a treadmill at 9 km/h using aleatory NIRO of 6 mm, NIRO of 8 mm, TMEO of 6 mm, TMEO of 8 mm, and sports shoes only (SO), while the muscular EMG of medial and lateral gastrocnemius activity during 30 s was recorded. Statistical intraclass correlation coefficient (ICC) to test reliability was calculated and the Wilcoxon test of all five different situations were tested. Results: The reliability of values was almost perfect. Data showed that the gastrocnemius lateralis increased its EMG activity between SO vs. NIRO-8 mm (22.27 ± 2.51 vs. 25.96 ± 4.68 mV, p < 0.05) and SO vs. TMEO-6mm (22.27 ± 2.51 vs. 24.72 ± 5.08 mV, p < 0.05). Regarding gastrocnemius medialis, values showed an EMG notable increase in activity between SO vs. NIRO-6mm (22.93 ± 2.1 vs. 26.44 ± 3.63, p < 0.001), vs. NIRO-8mm (28.89 ± 3.6, p < 0.001), and vs. TMEO-6mm (25.12 ± 3.51, p < 0.05). Conclusions: Both TMEO and NIRO have shown an increased EMG of the lateralis and medialis gastrocnemius muscles activity during a full running cycle gait. Clinicians should take into account the present evidence when they want to treat I MTPJ restriction with orthoses, and consider the inherent triceps surae muscular cost relative to running economy.

Vertebral disorders have significant health and economic impacts, and due to aging and current lifestyle habits, there is a trend toward their increase. Obesity and the alignment of vertebral curvatures can be associated with back pain. Objective: This study aims to analyze whether general and abdominal obesity are associated with cervical, dorsal, and lumbar vertebral pain as well as increased or decreased values of cervical, dorsal, and lumbar vertebral curvatures. Methodology: Body composition, degree of vertebral curvature, and the perception of cervical, dorsal, and lumbar pain were evaluated in a study population of 301 people (>18 years old). Linear and logistic regression analyses were performed to evaluate the influence of several variables of body composition on vertebral angles and cervical, dorsal, and lumbar pain. Results: Lumbar pain was the most prevalent (66.1%), mainly affecting women (70.9%). They were also shown to have greater lumbar angles (p < 0.001). The degrees of lumbar curvature increased, as did the BMI, waist circumference, and waist-to-height ratio. Cervical and dorsal curvatures were increased by all the variables of adiposity and abdominal adiposity. It was found that people with abdominal obesity carried twice the risk of lower back pain than those without abdominal obesity (OR = 2.172, p < 0.05). In addition, an increased lumbar angle was related to an increased risk of low back pain (OR = 1.031, p < 0.05). Cervical pain, on the other hand, was associated with the waist-height index (OR = 0.948, p <0.01). Conclusions: This study shows that increased lumbar curvature and abdominal obesity may be risk factors for lower back pain. In addition, it shows an association between the amount of body and abdominal fat in relation to the degree of curvature of the spine in the sagittal plane. Investigating the effect of obesity on vertebral morphology and musculoskeletal disorders makes it possible to prescribe interventions and therapeutic strategies.

The lateral wedge insole (LWI) is a typical orthopedic treatment for medial knee osteoarthritis pain, chronic ankle instability, and peroneal tendon disorders. It is still unknown what the effects are in the most important joints of the foot when using LWIs as a treatment for knee and ankle pathologies. Objectives: The aim of this study was to determine the influence of LWIs on the position of the midfoot and rearfoot joints by measuring the changes using a tracking device. Methods: The study was carried out with a total of 69 subjects. Movement measurements for the midfoot were made on the navicular bone, and for the rearfoot on the calcaneus bone. The Polhemus system was used, with two motion sensors fixed to each bone. Subjects were compared by having them use LWIs versus being barefoot. Results: There were statistically significant differences in the varus movement when wearing a 4 mm LWI (1.23 ± 2.08°, p < 0.001) versus the barefoot condition (0.35 ± 0.95°), and in the plantarflexion movement when wearing a 4 mm LWI (3.02 ± 4.58°, p < 0.001) versus the barefoot condition (0.68 ± 1.34°), in the midfoot. There were also statistically significant differences in the valgus movement when wearing a 7 mm LWI (1.74 ± 2.61°, p < 0.001) versus the barefoot condition (0.40 ± 0.90°), and in the plantar flexion movement when wearing a 4 mm LWI (2.88 ± 4.31°, p < 0.001) versus the barefoot condition (0.35 ± 0.90°), in the rearfoot. Conclusions: In the navicular bone, a varus, an abduction, and plantar flexion movements were generated. In the calcaneus, a valgus, an adduction, and plantar flexion movements were generated with the use of LWIs.

The first metatarsophalangeal joint (MTPJ), which includes the first metatarsal and proximal phalanx, plays a crucial role in gait and impacts the windlass mechanism. Disruptions to this mechanism are implicated in various foot pathologies. Jack’s Test serves as a valuable tool for clinicians to assess the functionality of the MTPJ. Varus rearfoot wedges (VRFWs) are a common treatment employed in the management of lower limb pathologies. The impact of VRFWs on the resistance of the first MTPJ during Jack´s Test is currently unknown. This study aimed to measure the influence of VRFWs on the resistance of the first MTPJ during Jack´s Test. The secondary objective was to validate a new measurement method using a digital force gauge. Thirty participants (17 women and 13 men) were enrolled. A digital force gauge measured the weight-bearing force needed for Jack’s Test, thereby evaluating the effects of VRFWs of different angulations. The Kolmogorov–Smirnov test confirmed that the data followed a normal distribution (p > 0.05). The nonparametric Friedman test (p < 0.001) showed that there were significant differences among all VRFWs, while the Wilcoxon test (p < 0.001) showed that there were differences between barefoot conditions and 3°, 5°, and 8° VRFWs. Results: The use of 8° VRFWs yielded a statistically significant reduction in the passive dorsiflexion force of hallux during Jack’s Test (12.51 N ± 4.12, p < 0.001). The use of VRFWs has been observed to reduce dorsiflexion resistance in the proximal phalanx of the first MTPJ during Jack’s Test. Additionally, the digital force gauge was proven to be a valid tool for conducting Jack’s Test, thus offering a reliable measurement method.

The hallux dorsiflexion resistance test is a frequently employed clinical maneuver for assessing the initiation of the windlass mechanism This maneuver involves dorsiflexion of the phalanx of the hallux, thereby evaluating plantarflexion of the first metatarsal, elevation of the medial longitudinal arch, and supination of the rearfoot. The windlass mechanism plays a crucial role in gait, and orthopedic devices, such as a kinetic wedge, which aims to facilitate its activation by increasing the hallux dorsiflexion. Although it is believed that facilitating the windlass mechanism with the kinetic wedge should be directly correlated with a decrease in hallux dorsiflexion resistance, its effects have yet to be characterized. Thus, this study aimed to determine the influence of a kinetic wedge on hallux dorsiflexion resistance in asymptomatic individuals. The sample comprised thirty participants (14 women and 16 men). A digital force gauge measured the force required to perform the hallux dorsiflexion resistance test during two conditions: barefoot and with a kinetic wedge. The Wilcoxon signed-rank test was used to compare the hallux dorsiflexion resistance between conditions. A statistically significant reduction in force (10.54 ± 3.16N vs. 19.62 ± 5.18N, p < 0.001) was observed when using the kinetic wedge compared to the barefoot condition during the hallux dorsiflexion resistance test. The use of a kinetic wedge reduces the required force for performing the passive hallux dorsiflexion resistance test in asymptomatic individuals. Future studies should determine to what extent the kinetic wedge can attenuate the required force to dorsiflex the hallux in individuals with musculoskeletal disorders such as plantar fasciopathy and functional hallux limitus.