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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 17  |  Issue : 1  |  Page : 34-37

A research protocol of foot posture in traffic policeman


Department of Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India

Date of Submission23-Apr-2021
Date of Decision28-Sep-2021
Date of Acceptance16-Dec-2021
Date of Web Publication25-Jul-2022

Correspondence Address:
Dr. Waqar Naqvi
Department of Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_178_21

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  Abstract 


Background: Traffic police officers have a high-risk job as said by Driscoll. They also have many health-related issues due to their occupation. Mostly, their physical health is affected because of their long hours of standing duty on the road, exposure to sun and cold, constant travelling on bike throughout the day. In this research, we used foot posture index (FPI)-6 a novel method of rating foot posture using the set criteria and a simple scale. It is a clinical tool used to quantify the degree to which a foot is pronated, neutral, or supinated. Materials and Methods: The study has been structured as a cross-sectional survey. The total of 132 participants will be taken from traffic department policemen of Wardha city unit excluding policemen who were on leave or suffering from foot injuries. The study procedure will involve permission to conduct medial arch assessment for traffic policemen through DCP, Wardha. Demographic details such as gender and age will recorded and also weight and height will be taken to calculate body mass index for each individual. Weight will be taken with and without gadgets. Discussion: This study protocol aims to evaluate the foot posture evaluation of policeman of Wardha City. The study's expected outcome will concert on the evaluation of foot posture using FPI in traffic police officers of Wardha City.

Keywords: Foot posture evaluation, foot posture index, policeman


How to cite this article:
Nurai T, Naqvi W. A research protocol of foot posture in traffic policeman. J Datta Meghe Inst Med Sci Univ 2022;17:34-7

How to cite this URL:
Nurai T, Naqvi W. A research protocol of foot posture in traffic policeman. J Datta Meghe Inst Med Sci Univ [serial online] 2022 [cited 2022 Aug 18];17:34-7. Available from: http://www.journaldmims.com/text.asp?2022/17/1/34/352216




  Introduction Top


According to the World Health Organization, occupational health is defined as “the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations by preventing departures from health, controlling risks and the adaption of work to people, and people to their jobs.”[1] Traffic police officers have a high-risk job as said by Driscoll. They also have many health-related issues due to their occupation. Mostly their physical health is affected because of their long hours of standing duty on the road, exposure to sun and cold, constant travelling on bike throughout the day.[2] It is observed that traffic police officers who are on the streets everyday are prone to developing varicose veins of lower limbs due to damage of valves. This leads to swelling and discomfort. They are also prone to joint problems and photosensitivity due to long hour exposure in the sun. The unhealthy diet and irregular eating time and lack of exercise make them obese and the long static standing hours makes their body stiff. Improper footwear they use also causes foot posture-related problems, especially as they require standing for long hours.

Pesplanus (flatfoot) is one of the most common conditions observed in adult health practice. The true prevalence of flatfoot is unknown, mainly because there are no such clinical or radiographic criteria for defining a flatfoot. Adult flatfoot is defined as a foot condition that persists or develops after skeletal maturity and is characterized by partial or complete loss or collapse of medial longitudinal arch. Adult flatfoot may present as an incidental finding or as a symptomatic condition with clinical consequences ranging from mild limitations to severe disability and pain causing major impediments. The adult flat foot is often a complex disorder with variety of symptoms and various degrees of deformity. Pathology and symptoms are caused by structural loading changes along the medial foot and plantar arch, as well as by collapse through the mid-foot and impingement along the lateral column and rear-foot. Muscles in the leg and foot tend to fatigue and cramp because of overuse.[3]

Although obesity and overweight is a temporary, it can be the cause of flatfoot. The foot adapts itself under loading condition by maintaining the medial longitudinal arch. Increasing the loading further activates compensatory mechanisms which maintain the longitudinal arch and shifts the loads to the central and medial forefoot.[4] The foot posture index (FPI)-6 is a novel method of rating foot posture using set criteria and a simple scale. It is a clinical tool used to quantify the degree to which a foot is pronated, neutral, or supinated. It is a measure of standing foot posture and so is not a replacement for gait assessment where time and facilities exist. It is however a more valid approach than many of the static weight bearing and nonweight bearing goniometric measures currently used in clinic.[5],[6],[7],[8],[9],[10]

Aim and objectives

The aim of this study is to evaluate foot posture in traffic policemen.


  Materials and Methods Top


Materials used

  • Consent form
  • FPI scale.


Methods

This study is a cross-sectional survey which will be carried out on traffic policemen of Wardha city unit excluding policemen who were on leave or suffering from foot injuries.

The study procedure will involve permission to conduct medial arch assessment for traffic policemen through DCP, Wardha. Demographic details such as gender and age will recorded and also weight and height will be taken to calculate body mass index for each individual. Weight will be taken with and without gadgets.

Instrumentation

  • FPI.


This test has been selected for the study because

  • It is simple and convenient
  • It is time efficient to perform
  • Does not involve costly technology
  • Results of the measure simple to understand
  • Reliability of this index is 0.98.


Study type

Observational.

Sampling technique

Simple random sampling.

Study setting

Wardha district.

Sample size

One hundred and fifty-two policemen.

Study duration

One month.

Inclusion criteria

  1. Traffic police with more than 1 year of experience
  2. Complaint of foot pain.


Exclusion criteria

  1. Traumatic injuries of lower limb
  2. Neurological problems
  3. Musculoskeletal problem other than foot.


Procedure

  • The FPI is a diagnostic clinical tool aimed at quantifying the degree to which a foot can be considered to be in a pronated, supinated, or neutral position
  • These measures give an overall view of the foot posture and its deviations from alignment
  • The reliability of this index is 0.98, and hence, it is a reliable test to perform.


The foot posture index includes 6 criteria

  1. Talar head palpation
  2. Supra and infra lateral malleolar curvature
  3. Calcaneal frontal plane position
  4. Prominence in the region of talonavicular joint
  5. Congruence of the medial longitudinal arch
  6. Abduction/adduction of the fore foot on the rear foot.


  • Each of the component is graded from zero to neutral with a minimum score of −2 for clear signs of supination, and +2 for positive signs of pronation
  • The patient should stand in their relaxed stance position with double limb support. Patient should be instructed to stand still, with their arms by their side and looking straight ahead
  • During the assessment, it is important to ensure that the patient does not swivel around to see what is happening for themselves, as this will significantly affect foot posture
  • Patient will need to stand approximately for 2 mins in total, in order for assessment to be conducted.


Talar head palpation

Head of the talus is palpated on the medial and lateral side of the anterior aspect of ankle, according to the standard method described. The scoring for the same is as given below.

Supra and infra lateral malleolar curvature

In the neutral foot, it has been suggested that the curves should be approximately equal. In the pronated foot, the curve below the malleolus will be more acute than the curve above due to abduction of the foot and eversion of calcaneus. The opposite is true to the supinated foot.

Calcaneal frontal plane position

With the patient standing in relaxed stance position, the posterior aspect of calcaneus is visualized with the observer in line with the long axis of the foot.

Buldging in the region of the talo navicular joint

In the neutral foot the area of skin immediately superficial to the talo navicular joint (TNJ) will be flat. The TNJ becomes more prominent if the head of the talus is adducted in rear foot view. Bulging in this area is thus associated with pronating foot.

Height and congruence of medial longitudinal arch

In a neutral foot, the curvature of arch will be relatively uniform, similar to the segment of circumference of a circle. When the foot is supinated, the medial longitudinal arch curve becomes more acute at its posterior end. In an excessively pronated foot, the arch becomes flattened in the centre.

Abduction/adduction of the fore foot and the rear foot

When viewed directly from behind, and in line with the long axis of the heel, the neutral foot will allow the observer to see forefoot equally on medial and lateral sides. In the supinated foot, the fore foot will adduct on the rear foot resulting more of the fore foot being visible on the medial side. Conversely, pronation of the foot causes abduction of the rear foot resulting more of the fore foot being visible on the lateral side.

The FPI score will be a whole number between −12 and +12 [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6].
Figure 1: Talar head palpation

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Figure 2: Supra and infra lateral malleolar curvature

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Figure 3: Calcaneal frontal plane position

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Figure 4: Buldging in the region of the Talo Navicular Joint (TNJ)

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Figure 5: Height and congruence of medial longitudinal arch

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Figure 6: Abduction/ Adduction of the fore foot and the rear foot

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Ethical clearance

It has been obtained by Datta Meghe Ethical Committee, DMIMS, Sawangi Meghe Wardha.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Doctor AR, Phadke SS. Foot posture assessment in traffic policemen. IJPR 2017;5:2249-52.  Back to cited text no. 1
    
2.
Driscoll T. Coverage of work related fatalities in Australia by compensation and occupational health and safety agencies. Occup Environ Med 2003;60:195-200.  Back to cited text no. 2
    
3.
Tejashree B. Prevalence of flat foot among 18 -25 years old physiotherapy students: Cross sectional study. Indian J Basic Appl Med Res 2014;3:272-8.  Back to cited text no. 3
    
4.
Chougala A, Phanse VA, Khanna E, Panda S. Screening of body mass index and functional flatfoot in adult: An observational study. IJPR 2015;3:1037-41.  Back to cited text no. 4
    
5.
Scharfbillig R, Evans AM, Copper AW, Williams M, Scutter S, Iasiello H, et al. Criterion validation of four criteria of the foot posture index. J Am Podiatr Med Assoc 2004;94:31-8.  Back to cited text no. 5
    
6.
Redmond AC, Crane YZ, Menz HB. Normative values for the foot posture index. J Foot Ankle Res 2008;1:6.  Back to cited text no. 6
    
7.
Escamilla-Martínez E, Martínez-Nova A, Gómez-Martín B, Sánchez-Rodríguez R, Fernández-Seguín LM. The effect of moderate running on foot posture index and plantar pressure distribution in male recreational runners. J Am Podiatr Med Assoc 2013;103:121-5.  Back to cited text no. 7
    
8.
Keenan AM, Redmond AC, Horton M, Conaghan PG, Tennant A. The foot posture index: Rasch analysis of a novel, foot-specific outcome measure. Arch Phys Med Rehabil 2007;88:88-93.  Back to cited text no. 8
    
9.
Billis E, Katsakiori E, Kapodistrias C, Kapreli E. Assessment of foot posture: Correlation between different clinical techniques. Foot 2007;17:65-72.  Back to cited text no. 9
    
10.
Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: The Foot Posture Index. Clin Biomech (Bristol, Avon) 2006;21:89-98.  Back to cited text no. 10
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]



 

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