Study Design: Systematic literature review with meta-analysis. Objectives: To investigate the association between nonneutral foot types (high arch and flatfoot) and lower extremity and low back injuries, and to identify the most appropriate methods to use for foot classification. Methods: A search of 5 electronic databases (PubMed, Embase, CINAHL, SPORTDiscus, and ProQuest Dissertations and Theses), Google Scholar, and the reference lists of included studies was conducted to identify relevant articles. The review included comparative cross-sectional, case-control, and prospective studies that reported qualitative/quantitative associations between foot types and lower extremity and back injuries. Quality of the selected studies was evaluated, and data synthesis for the level of association between foot types and injuries was conducted. A random-effects model was used to pool odds ratio (OR) and standardized mean difference (SMD) results for meta-analysis. Results: Twenty-nine studies were included for meta-analysis. A significant association between nonneutral foot types and lower extremity injuries was determined (OR = 1.23; 95% confidence interval [CI]: 1.11, 1.37; P<.001). Foot posture index (OR = 2.58; 95% CI: 1.33, 5.02; P<.01) and visual/physical examination (OR = 1.17; 95% CI: 1.06, 1.28; P<.01) were 2 assessment methods using distinct foot-type categories that showed a significant association with lower extremity injuries. For foot-assessment methods using a continuous scale, measurements of lateral calcaneal pitch angle (SMD, 1.92; 95% CI: 1.44, 2.39; P<.00001), lateral talocalcaneal angle (SMD, 1.36; 95% CI: 0.93, 1.80; P<.00001), and navicular height (SMD, 0.34; 95% CI: 0.16, 0.52; P<.001) showed significant effect sizes in identifying high-arch foot, whereas the navicular drop test (SMD, 0.45; 95% CI: 0.03, 0.87; P<.05) and relaxed calcaneal stance position (SMD, 0.49; 95% CI: 0.01, 0.97; P<.05) displayed significant effect sizes in identifying flatfoot. Subgroup analyses revealed no significant associations for children with flatfoot, cross-sectional studies, or prospective studies on high arch. Conclusions: High-arch and flatfoot foot types are associated with lower extremity injuries, but the strength of this relationship is low. Although the foot posture index and visual/physical examination showed significance, they are qualitative measures. Radiographic and navicular height measurements can delineate high-arch foot effectively, with only anthropometric measures accurately classifying flatfoot. Level of Evidence: Prognosis, level 2a. J Orthop Sports Phys Ther 2013;43(10):700–714. Epub 11 June 2013. doi:10.2519/jospt.2013.4225

Objectives: In this study, the effect of shoe degradation on running biomechanics by comparing the kinetics and kinematics of running in new and worn shoes was investigated. Three types of footwear using different cushioning technologies were compared.Design: Longitudinal study.Setting: Pre- and post-tests on overground running at 4.5 m s⁻¹on a 20-m laboratory runway; performance measured using a force platform and a motion capture system.Participants: 24 runners (14 men and 10 women)Interventions: 200 miles of road running in the same pair of shoes. Within-group factor: shoe condition (new/worn); between-group factor: footwear type (air/gel/spring).Main outcome measurements: Stance time was calculated from force data. External loads were measured by maximum vertical force and loading rate. Kinematic changes were indicated by sagittal plane angles of the torso, hip, knee and ankle at critical events during the stance phase.Results: Stance time increased (p = 0.035) in worn shoes. The torso displayed less maximum forward lean (p<0.001) and less forward lean at toe-off (p<0.001), while the ankle displayed reduced maximum dorsiflexion (p = 0.013) and increased plantar flexion at toe-off (p<0.001) in worn shoes. No changes in the hip and knee angles. No between-group difference among the three footwear groups or condition by type interaction was found in any measured variables.Conclusions: As shoe cushioning capability decreases, runners modify their patterns to maintain constant external loads. The adaptation strategies to shoe degradation were unaffected by different cushioning technologies, suggesting runners should choose shoes for reasons other than cushioning technology.

This study examined the effects of 3 types of postactivation potentiation (PAP) protocols (single-joint isometric, multijoint isometric, and multijoint dynamic) on subsequent 10-m, 20-m and 30-m sprint performance in 12 well-trained male track athletes (mean ± SD age = 22.4 ± 3.2 years). The subjects performed 4 protocols in a randomized order on different days as follows: control (4 minutes of passive rest), maximum voluntary isometric knee extension (3 repetitions of 3-second isometric knee extension), maximum voluntary isometric back squat (3 repetitions of 3-second isometric squat), and dynamic back squat (3 repetitions of back squats at 90% 1 repetition maximum). After each protocol, a 4-minute recovery period was incorporated before a 30-m maximal sprint assessment. Maximal sprint times at 10 m, 20 m, and 30 m were measured using timing gates to reflect sprint performance. One-way repeated measures analyses of variance revealed no differences in sprint performance among the 4 protocols at 10-m, 20-m, or 30-m intervals. There were, however, large individual variations in the response to the PAP protocols with some athletes benefiting from the PAP effect and others not. In summary, this study showed no enhancement of short-distance sprint performance after PAP protocols with a 4-minute recovery period, regardless of isometric or dynamics, single-joint or multijoint. Coaches considering the use of PAP protocols to improve sprinting performance of their athletes should exploit the effectiveness of different PAP protocols on an individual basis.

We examined whether the momentary induction of state mindfulness benefited subsequent balance performance, taking into consideration the effects of dispositional mindfulness. We also tested whether our mindfulness induction, grounded in sustaining moment-to-moment attention, influenced the attentional focus strategies that were adopted by the participants during the balancing task. Balance performance was ascertained based on approximate entropy (ApEn) of the center of pressure (COP) data. The study involved 32 males (age: M = 22.8, SD = 1.94) who were randomly assigned to the mindfulness or control group. Using difference in pretest to posttest performance based on the medio-lateral movements as the dependent variable, the test for interaction showed that the mindfulness induction was more effective for participants with higher dispositional mindfulness. Participants who underwent mindfulness induction also reported greater use of external focus strategies than those in the control group. Results suggest that momentary mindful attention could benefit balance performance and affect the use of attentional focus strategies during movement control.