RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1. NAME AND ADDRESS OF THE CANDIDATE / BHAT ANSHITA CHANDRASHEKHARADepartment of physiotherapy
M.S. Ramaiah Medical college
M.S.R.I.T post
Bangalore- 560054
2. NAME OF THE INSTITUTION / Department of Physiotherapy
M.S. Ramaiah Medical college
M.S.R.I.T Post, Bangalore- 54
3. COURSE OF STUDY AND SUBJECT / Masters in Physiotherapy
(Musculoskeletal Disorders And Sports)
4. DATE OF ADMISSION TO COURSE / 20th June 2010
5. TITLE OF THE TOPIC / “Analysis of foot posture in basket ball players”
6 .BRIEF RESUME OF THE INTENDED WORK
6.1 NEED FOR THE STUDY
Basketball is a highly demanding and competitive sport. The game involves repetitive landing, running, sharp changes in direction and sideways cutting maneuver. Landing mechanism in basketball players is from forefoot to rear-foot or rear-foot landing. Landing on forefoot to rear-foot has three impact force-first on metatarsal head, second on calcaneum and third by peak dorsi-flexion range. Daniel Rojano in his study showed that landing forefoot to rear-foot has lower vertical ground reaction force (GRF) compared to rear-foot landing.1 It is thus hypothesized that this variation in vertical GRF can alter hind-foot posture in basketball players.
Alteration in rear-foot posture has shown to predispose lower extremity overuse injury in basketball players. In an epidemiological study conducted on professional basketball players, ankle sprains were found to be the most prevalent of the injuries followed by patello-femoral inflammation, lumbar strain and knee sprain respectively.2
Landing on excessive supinated rear-foot has shown to cause lateral ligament sprain of ankle,3and also overload the lateral column of the foot predisposing to Jones fracture.4
On the other aspect, excessive subtalar pronation causes excessive anterior tibial translation and predisposes the individual to ACL injury.5 It is also found that pronated foot causes shin pain due to the overuse of superficial and deep muscles around tibia.6
Therefore to reduce the risk of injuries in the lower extremity that can occur because of excessive pronation or supination of the hind foot there is a need to assess hind foot posture in basketball players.
NULL HYPOTHESIS
There will be no significant difference in foot posture between basketball players and control group.
RESEARCH HYPOTHESIS-
There will be significant difference in foot posture between basketball players and control group.
6.2 REVIEW OF LITERATURE
Becky Woodford –Rogers and Lynne Cyphert conducted a study on ACL injured football players, gymnast and basketball players versus uninjured A.C.L group. They found that A.C.L injured group had greater navicular drop scores, suggesting subtalar pronation and greater anterior knee joint laxity.7
Hertel Jay studied the functional anatomy, patho- mechanics and patho- physiology of ankle instability on athletes. They concluded that during the jump supination of rare foot about an externally rotated lower leg causes lateral ankle sprain.3
Fernandez M. fairen et.al studied fracture healing by screw fixation of the fifth metatarsal in basketball players. They found that with cavus foot type stress fracture of fifth metatarsal took 8 to 14 weeks to heal completely.8
Menz HB et al reported that Foot posture index is a valid tool to asses posture of the foot .They found that foot posture index, navicular height and arch index of each patients correlated with radiographic measurements.9
The above literature suggest that both pronated and supinated foot causes lower extremity overuse injury. Therefore to reduce the risk of injuries in the lower extremity that can occur because of excessive pronation or supination of the hind foot there is a need to assess hind foot posture in basketball players.
OBJECTIVES OF THE STUDY
1. To determine the foot posture in basketball players
2. To determine the foot posture in control group
3. To compare the foot posture between basketball players and control group.
7. MATERIAL AND METHODS
7.1 SOURCES OF COLLECTION OF DATA:
60 elite “basketball player” from district, state and national level, playing for Karnataka state or ‘A ‘division leagues or clubs will be taken as subjects.
7.2 METHOD OF COLLECTION OF DATA
Method of sampling: Convenience sampling
Type of study: Comparative study
Proposed sample size: 60 study group and 60 control group
Procedure Of data collection for study group:
An ethical clearance will be obtained from the ethical committee of M.S Ramaiah Medical College.
Elite Basketball players who are currently playing for district, state and national level will be taken as subjects for study group. Subjects not involved in professional sports activity or recreational sports activity of same age group will be taken as control group. Informed consent will be taken from the subjects. The subjects who satisfy the inclusion criteria will be included in the study. Foot posture will be assessed using the foot posture index.
FOOT POSTURE INDEX
Foot posture index is made up of six components measuring foot posture in three body planes. The scoring system uses a 5-point Likert-type scale where lower scores represent a more supinated foot position and a higher scores a more pronated position. All components will be scored based on observation except talar head palpation. Participants will be asked to stand in relaxed stance with double limb support. Subjects will be asked to march for some time on spot before taking measurement and then to relax and stand still with their arms by their side and looking straight ahead the six criteria to be observed for measuring foot posture are:
1. Talar head palpation
2. Curves above and below lateral malleoli
3. Inversion and eversion of the calcaneus in frontal plane
4 . Buldge in the region of talonavicular joint
5. Congruence of medial longitudinal arch
6. Abduction and adduction of the forefoot on the rarefoot
INCLUSION CRITERIA OF STUDY GROUP:
1. Age-18-25 years
2. History of playing atleast 5 years
3 Atleast 12 hours of exposure to play/week
EXCLUSION CRITERIA FOR STUDY GROUP
1. History of recent injury of lower limb
2. Obvious deformity of lower limb
INCLUSION CRITERIA FOR CONTROL GROUP
1. 18-25years
2. No professional sports activity
EXCLUSION CRITERIA FOR CONTROL GROUP
1 .Recent injury of lower limb
2. Obvious deformity of lower limb
Materials used:
1. Foot posture index
2. Goniometer
3. Water soluble marker pen
Foot posture index will be calculated as an aggregate of scores obtained from the six individual components. A total score between 0 to+5 will be considered as normal score. Scores between +6 to +9 will indicate presence of pronated foot while scores between -1 to -4 will be considered as supinated foot.
STASTICAL METHOD
Independent t test
Mann Whitney U test
7.3 Does the study require any investigation or intervention to be conducted
on patient or other human or animals? No
7.4 Has ethical clearance been obtained from the institution? YES
8. LIST OF REFERENCES
1) Daniel Rojano Ortega et al. Analysis of vertical ground reaction forces and temporal factors in landing phase of a countermovement jump. Journal of sports science and medicine 2010;9:282-287.
2) Chad Starkey et al. Injury and illness in national basketball association: A 10 years perspective study. Journal of athletic training 2000; 35:161-167.
3) Jay Hertel et al. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability Journal of athletic training 2002; 37(4):364-375.
4) Steven M Raikin et al. Asessment of varus hindfoot and fracture of 5th metatarsal metaphyseal diaphyseal junction. American Journal of Sports medicine .2008;36(7):1367-1372.
5) Ireland M.l et al. Anterior cruciate ligament injury in female athletes epidemiology. Journal of athletic training, 1999; 34(2):150-154.
6) Douglas. B.Mckaeg., Handbook of Sports Medicine and Science, Chapter 15,Karimkhan and Jill Cook, Blackwell, Malden, Massachussetts, U.S.A, 2003,. pp191.
7) Becky Woodford-Rogers, Lynne Cyphert et al. Risk factor for anterior cruciate ligament injury in high school and college athletes .Journal of athletic training 1994;4:343-346.
8) M.Fernandes Ferian et al. Fracture of fifth metatarsal in basketball players. Knee surgery sports traumatol arthroscopy.1999; 7:373-377.
9) Menz H.B Munteanuse et al. Validity of 3 clinical technique for measurement of foot posture in older people. Journal of orthopedic and sports physical therapy 2005; 35(8):479-486.
9. SIGNATURE OF THE CANDIDATE:10. REMARK OF THE GUIDE:
11.1 NAME AND DESIGNATION OF
GUIDE: / Mrs. JUDITH ROWENA W
ASSISTANT PROFESSOR
DEPARTMENT OF PHYSIOTHERAPY
M.S. RAMAIAH MEDICAL COLLEGE
11.2 SIGNATURE:
11.3 CO-GUIDE: / Mrs. SHOBHA LAKASHMI
ASSISTANT PROFESSOR
DEPARTMENT OF PHYSIOTHERAPY
M.S.RAMAIAH MEDICAL COLLEGE
11.4 SIGNATURE:
11.3 HEAD OF THE DEPARTMENT : / PROF.SAVITA RAVINDRA
HEAD OF THE DEPARTMENT
DEPARTMENT OF PHYSIOTHERAPY
M.S RAMAIAH MEDICAL COLLEGE
11.4 SIGNATURE:
12
12.1 REMARKS OF THE CHAIRMAN
AND PRINCIPAL:
12.2 SIGNATURE:
ANNEXUREI
Informed consent
“Analysis of food posture in basket ball players”
Respected Sir/Madam
Basket ball player have altered landing mechanism during playing they land from toe to heel or only heel. Landing on heel has greater risk of injury. Therefore this study is undertaken to analyze foot posture in basket ball players.
The benefit of this research will reduce the risk of re injury by implementing measure.
Consent from the subject
I, Mr./Ms. ……………………………………… of age ……….. years, have been informed about the study “Analysis of food posture in basketball players” by Ms. ANSHITA BHAT. I have had the opportunity to ask questions. All my questions about the study and my part in it have been answered to my satisfaction.
I freely consent to be in this research study.
Name of the subject ………………………… Date ……………………
Signature of the subject …………………………….
ANNEXURE II
ASSESSMENT PROFORMA
DEMOGRAPHIC DATA :
1 NAME :
2 AGE :
3 SEX :
4 ADDRESS :
5 PHONE NUMBER :
6 HEIGHT :
7 WEIGHT :
8 DATE :
9 LIMB LENGTH :
10 PLAYING FOR (NATIONAL,STATE,OR ZONAL LEVEL)
11 NO. OF YEARS OF PLAYING
12 DURATION OF PLAYING
13 INVOLVEMENT IN OTHER RECREATIONAL SPORTS ACTIVITY:
OUTCOME MEASURE:
FOOT POSTURE INDEX -
FACTOR / LEFT(-2 TO +2) / RIGHT
(-2 TO+2)
Talar head palpation
Curves above and below lateral malleolli
Inversion/ Eversion of the calcaneus
Prominence in the the region of TNJ
Congruence of the medial longitudinal arch
Abduction/adduction forefoot on rearfoot
TOTAL