Background: A number of multi‐segment foot protocols have been proposed to obtain measurements of clinical value. In the clinical assessment of foot pathologies and deformities, such as in the pes‐planus, the frontal‐plane alignment of the calcaneus and the dynamic properties of the medial longitudinal arch are critical parameters though often neglected by the majority of foot protocols. The aim of the present work is to modify an established foot protocol to obtain static and kinematic measures more consistent with corresponding clinical observations. Moreover, while many papers have reported kinematic data from varying populations, few investigations have focussed on young participants from same‐age cohorts.Methods: A 6‐camera motion capture system was employed to track the shank, rear‐, mid‐ and fore‐foot segments in the left and right leg of 10 children (13.1 ± 0.8 years) during gait. Three markers were attached to each segment thus allowing for triplanar motion of five joints to be described according to the Rizzoli Foot Model. An additional marker was attached to the posterior bottom of the calcaneus to enhance measurement of frontal‐plane orientation. Description of the medial longitudinal arch angle was redefined to be more consistent with rearfoot orientation and to common clinical assessments. A novel 3‐marker description of the hallux segment was implemented to improve robustness in calculating 1^st metatarso‐phalangeal joint rotations.Results: Foot segments kinematics showed good inter‐ participant repeatability and overall consistency with previous similar reports. 15 out of 20 feet showed neutral or slightly valgus orientation of the calcaneus. Relatively large medial longitudinal arch angles (mean 186 ± 16 deg) were found in the present young population. Both measurements were reasonably in accordance with the relevant clinical observations of these feet.Conclusions: Modifications to a widely used multisegmental foot kinematic model were implemented to improve robustness and consistency with relevant clinical observations. A detailed description of foot joints motion during barefoot walking in a population of 13‐year old children with apparent flat feet has been presented, which may provide useful information to investigate the development of gait in children and the diagnosis of flexible flat foot.

Background: Plano‐valgus is a common alteration of the paediatric foot, characterized by valgus hindfoot, foot pronation and drop of the medial longitudinal arch. Despite their importance in the diagnosis and classification of plano‐valgus foot condition, little information is available on functional alterations of the major joints spanning the medial longitudinal arch – i.e. midtarsal and tarso‐metatarsal. Aim of the study was to provide objective description of the alterations in plano‐valgus midfoot joints with respect to those in an age‐matched normally‐developed feet population.Methods: Twenty adolescents (13.3 ± 0.8 years) with bilateral plano‐valgus feet underwent clinical examination and were gait‐analysed via a validated 4‐segment foot model. This allowed to measure static foot posture, kinematics of the main foot joints, and medial longitudinal arch deformation during walking at comfortable speed. Range of motion and temporal profiles of joint rotations were compared to those from a control population of age‐matched adolescents with normally‐developed feet.Results: The plano‐valgus midtarsal joint was more dorsiflexed, everted and abducted than that in the control group, and showed reduced sagittal‐plane RoM (plano‐valgus = 15.9 degrees; control = 22.2 degrees; P < 0.01). The tarso‐metarsal joint was more plantarflexed and adducted, and showed larger frontal‐plane RoM. The MLA showed larger RoM and was lower throughout the stance phase of the gait cycle.Conclusion: Significant postural and kinematic alterations are present at the midtarsal and tarso‐metarsal joints of adolescents with plano‐valgus feet. Objective identification and quantification of plano‐valgus foot alterations, via non‐invasive gait‐analysis, is relevant to improving the diagnosis of this condition and to evaluating the effect of conservative treatments and of surgical corrections by different techniques.

Walking is one of the main activities of daily life and gait analysis can provide crucial data for the computation of biomechanics in many fields. In multiple applications, having reference data that include a variety of gait conditions could be useful for assessing walking performance. However, limited extensive reference data are available as many conditions cannot be easily tested experimentally. For this reason, a musculoskeletal model in OpenSim coupled with gait data (at seven different velocities) was used to simulate seven carried loads and all the combinations between the two parameters. The effects on lower limb biomechanics were measured with torque, power, and mechanical work. The results demonstrated that biomechanics was influenced by both speed and load. Our results expand the previous literature: in the majority of previous work, only a subset of the presented conditions was investigated. Moreover, our simulation approach provides comprehensive data that could be useful for applications in many areas, such as rehabilitation, orthopedics, medical care, and sports.

Multiple Myeloma is a cancer of B plasma cells, which produce non-specific antibodies and proliferate uncontrolled. Due to the potential relapse and non-specificity of current treatments, immunotherapy promises to be more specific and may induce long-term immunity in patients. The pituitary tumor transforming gene 1 (PTTG-1) has been shown to be a novel oncogene, expressed in the testis, thymus, colon, lung and placenta (undetectable in most other tissues). Furthermore, it is over expressed in many tumors such as the pituitary adenoma, breast, gastrointestinal cancers, leukemia, lymphoma, and lung cancer and it seems to be associated with tumorigenesis, angiogenesis and cancer progression. The purpose was to investigate the presence/rate of expression of PTTG-1 in multiple myeloma patients.

Hip problems in cerebral palsy are relatively frequent (25–75%). Subluxation and dislocation of the hip is proportional to the neuromuscular involvement and is often due to alteration caused by spastic muscle forces acting on the femoral head in the acetabular cavity.The EMMA approach (Early Multilevel Minimally-invasive Approach) has been designed to restore muscle balance, decrease hip migration and prevent bone deformities thereby avoiding future pain with minimal biological cost to the patient. EMMA is suitable for most patients, especially those with increased tone, poor muscle control and selectivity, Reimer Index (R.I.) 20%.We consider age and R.I crucial prerequisites for treatment steps.EMMA 1) age 2–4 years, RI 20%: multilevel injection of botulinum toxin in case of muscular hyperactivity without morphological alterations of the couple muscle-tendon (contractures).EMMA 2) age 4–6, RI 20%: multilevel aponeurectomies in case of muscular hyperactivity with morphological alterations of the couple muscle-tendon (retraction).EMMA 3) early bone surgery (growth plates).This approach has been adopted in the last 4 years to prevent bone deformities and give early mobilisation and early control of the pain. EMMA is simple to apply even in infants, both for hip containment and to decrease spasticity.