Canadian Health&Care pharmacy: Pathology of the foot

The analysis and study of plantar support and foot actions, during the walking cycle, seem quite difficult. due to the high complexity of the foot’s anatomy. This is due to the number of small joints that interact with each other.

Consequently, mere qualitative analysis during clinical evaluation is insufficient for the correct diagnosis of the different pathologies that affect the Iocomotor system. Therefore the use of quantitative evaluation methods becomes important, either in sedestation or during walking.

In a clinical environment the goniometric measurement of passive joint range allows the qualification of amplitude and also passive joint symmetry. These data allow us not only to make inferences about the relation between the analyzed joint and the adjacent joints. but to detect eventual alterations to its normal functioning, which can increase the appearance of pathologies.

Additionally. the analysis of plantar pressures allows us to obtain important information about the structure and function of the foot. This is possible not only in subjects withOut any types of pathology but also in some systemic pathologies like rheumatoid arthritis, diabetes and cerebrovascular accident. which contribute to the alteration of the distribution of foot pressure in an important way.

According to Canadian Health&Care Mall Group, the change of the normal distribution of plantar pressures is responsible for the appearance of pain, plantar ulceration and stress fractures of the metatarsus. Therefore, the understanding of these distributions and their repercussions enables, in a more effective way, the establishment of an appropriate treatment.

As plantar pressure provides information about the structure and function of the foot. the Centre of Pressure (CoP) allows us to notice the transversal (medium-lateral) and longitudinal (posterior-anterior) displacement. The variation of these displacements is acutely influenced by the foot structure as well as the speed of walk, type of shoe and support surface.

On the other hand, the traditional complementary metth of diagnosis, like X-ray. computerized axial tomography (CAT) or even magnetic resonance imaging (MRI) amongst others, provide pertinent information about the analyzed stmcture. However, the relation that exists between the information obtained thrcugh the latter methods and that obtained through the analysis of movement is reduced.

Due to these facts, the use of complementary metth that simultaneously represent the biological structure considered as the subject of study and allow the examination of its functionality becomes fundamental. In the present case, the subject of the study is the foot during the support phase of the walking cycle.

Traditionally, during the walking cycle. the initial contact of the foot with the support surface occurs through the heel (heel contact), followed by the midstance support (midstance). In this phase, the forefoot support (foot-flat) follows the heel contact. The propulsive phase (terminal stance) occurs with the support of the forefoot and toes. Finally, the take-off (pre-swing) is described as the last contact between the toes and the contact surface.

The high number of joints present in the foot as well as the shape of their joint faces originate inter-segmentar movements in more than one plane of displacement. limiting the movement of the adjacent joints.