1
|
Donoso-Úbeda E, Ucero-Lozano R, Meroño-Gallut J, Cuesta-Barriuso R, Pérez-Llanes R. Safety and efficacy of myofascial release therapy in the treatment of patients with hemophilic ankle arthropathy. Single-blind randomized clinical trial. Physiother Theory Pract 2024:1-10. [PMID: 38530214 DOI: 10.1080/09593985.2024.2334752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Hemophilia is characterized by degenerative joint damage. Patients with hemophilic arthropathy present joint damage, reduced range of motion, and decreased strength and functional capacity. Myofascial release therapy aims to decrease pain and improve tissue mobility and functionality. OBJECTIVES To evaluate the safety and efficacy of myofascial release therapy in patients with hemophilic ankle arthropathy. METHOD Single-blind randomized controlled trial. Fifty-eight adult patients with hemophilia were randomly allocated to the experimental group (myofascial release therapy with foam roller) or the control group (no intervention whatsoever). The daily home protocol of myofascial release therapy for the lower limbs using a foam roller lasted eight consecutive weeks. The primary variable was the safety of myofascial release therapy (weekly telephone follow-up). The secondary variables were pain intensity (visual analog scale), range of motion (goniometer), functional capacity (2-Minute Walk Test) and muscle strength (dynamometer), at baseline and at 8 and 10 weeks. RESULTS During the experimental phase, none of the patients in the experimental group developed ankle hemarthrosis. There were statistically significant changes in time*group interaction in ankle dorsal flexion (F[1.75] = 10.72; p < .001), functional capacity (F[1.16] = 5.24; p = .009) and gastrocnemius strength (F[2] = 26.01; p < .001). The effect size of the changes after the intervention was medium-large in pain intensity (d = -1.77), functional capacity (d = 1.34) and gastrocnemius strength (d = 0.76). CONCLUSION Myofascial release therapy is a safe form of physical therapy for patients with hemophilia. Myofascial release therapy can effectively complement prophylactic pharmacological treatment in patients with hemophilic arthropathy, improving range of motion in dorsal flexion, functional capacity and gastrocnemius strength.
Collapse
Affiliation(s)
- Elena Donoso-Úbeda
- Department of Physiotherapy, Catholic University San Antonio-UCAM, Murcia, Spain
- InHeFis Research Group, Instituto Asturiano de Investigación ,Sanitaria (ISPA), Oviedo, Spain
| | - Roberto Ucero-Lozano
- InHeFis Research Group, Instituto Asturiano de Investigación ,Sanitaria (ISPA), Oviedo, Spain
- Department of Physiotherapy, European University of Madrid, Madrid, Spain
| | - Javier Meroño-Gallut
- InHeFis Research Group, Instituto Asturiano de Investigación ,Sanitaria (ISPA), Oviedo, Spain
- Tú. Bienestar 360°, Physiotherapy and Medical Center, San Javier, Murcia, Spain
| | - Rubén Cuesta-Barriuso
- InHeFis Research Group, Instituto Asturiano de Investigación ,Sanitaria (ISPA), Oviedo, Spain
- Department of Surgery and Medical-Surgical Specialties, University of Oviedo, Oviedo, Spain
| | - Raúl Pérez-Llanes
- InHeFis Research Group, Instituto Asturiano de Investigación ,Sanitaria (ISPA), Oviedo, Spain
- Department of Physiotherapy, University of Murcia, Murcia, Spain
| |
Collapse
|
2
|
Koshino Y, Takabayashi T, Akuzawa H, Mizota T, Numasawa S, Kobayashi T, Kudo S, Hikita Y, Akiyoshi N, Edama M. Differences and relationships between weightbearing and non-weightbearing dorsiflexion range of motion in foot and ankle injuries. J Orthop Surg Res 2024; 19:115. [PMID: 38308266 PMCID: PMC10837980 DOI: 10.1186/s13018-024-04599-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/28/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND This study aimed to: (1) identify assessment methods that can detect greater ankle dorsiflexion range of motion (DROM) limitation in the injured limb; (2) determine whether differences in weightbearing measurements exist even in the absence of DROM limitations in the injured limb according to non-weightbearing measurements; and (3) examine associations between DROM in the weightbearing and non-weightbearing positions and compare those between a patient group with foot and ankle injuries and a healthy group. METHODS Eighty-two patients with foot and ankle injuries (e.g., fractures, ligament and tendon injuries) and 49 healthy individuals participated in this study. Non-weightbearing DROM was measured under two different conditions: prone position with knee extended and prone position with knee flexed. Weightbearing DROM was measured as the tibia inclination angle (weightbearing angle) and distance between the big toe and wall (weightbearing distance) at maximum dorsiflexion. The effects of side (injured, uninjured) and measurement method on DROM in the patient groups were assessed using two-way repeated-measures ANOVA and t-tests. Pearson correlations between measurements were assessed. In addition, we analyzed whether patients without non-weightbearing DROM limitation (≤ 3 degrees) showed limitations in weightbearing DROM using t-tests with Bonferroni correction. RESULTS DROM in patient groups differed significantly between legs with all measurement methods (all: P < 0.001), with the largest effect size for weightbearing angle (d = 0.95). Patients without non-weightbearing DROM limitation (n = 37) displayed significantly smaller weightbearing angle and weightbearing distance on the injured side than on the uninjured side (P < 0.001 each), with large effect sizes (d = 0.97-1.06). Correlation coefficients between DROM in non-weightbearing and weightbearing positions were very weak (R = 0.17, P = 0.123) to moderate (R = 0.26-0.49, P < 0.05) for the patient group, and moderate to strong for the healthy group (R = 0.51-0.69, P < 0.05). CONCLUSIONS DROM limitations due to foot and ankle injuries may be overlooked if measurements are only taken in the non-weightbearing position and should also be measured in the weightbearing position. Furthermore, DROM measurements in non-weightbearing and weightbearing positions may assess different characteristics, particularly in patient group. LEVEL OF EVIDENCE Level IV, cross-sectional study.
Collapse
Affiliation(s)
- Yuta Koshino
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-Ku, Sapporo, 060-0812, Japan.
| | - Tomoya Takabayashi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Hiroshi Akuzawa
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Takeshi Mizota
- Department of Rehabilitation, Soejima Orthopedic Hospital, Takeo, Saga, Japan
| | - Shun Numasawa
- Department of Rehabilitation, Takarazuka University of Medical and Health Care, Takarazuka, Japan
| | - Takumi Kobayashi
- Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Chitose, Japan
| | - Shintarou Kudo
- Inclusive Medical Sciences Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
- AR-Ex Medical Research Center, Tokyo, Japan
| | | | - Naoki Akiyoshi
- Department of Rehabilitation, J Medical Oyumino, Chiba, Japan
| | - Mutsuaki Edama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| |
Collapse
|
3
|
Shi X, Ganderton C, Tirosh O, Adams R, Ei-Ansary D, Han J. Test-retest reliability of ankle range of motion, proprioception, and balance for symptom and gender effects in individuals with chronic ankle instability. Musculoskelet Sci Pract 2023; 66:102809. [PMID: 37354602 DOI: 10.1016/j.msksp.2023.102809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/15/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVES To determine the reliability of the commonly used musculoskeletal assessments in individuals with chronic ankle instability (CAI). DESIGN Within and between-days test-retest reliability. SETTING University laboratory. PARTICIPANTS Twenty-four individuals with unilateral CAI. METHOD For both sides, ankle dorsiflexion range of motion (DFROM) was assessed by a goniometer and weight-bearing lunge test (WBLT), proprioception by the active movement extent discrimination apparatus (AMEDA), and balance by the Star Excursion Balance Test with anterior (SEBTA), posteromedial (SEBTPM) and posterolateral (SEBTPL) components. All measures were taken at enrollment, after 30 min and one week later. RESULTS For the asymptomatic side, all assessments demonstrated good to excellent reliability, with ICCs (3,1) between 0.8 and 0.96. On the symptomatic side, WBLT, SEBTA and SEBTPM showed excellent reliability, with ICCs (3,1) above 0.90, while SEBTPL, goniometer and AMEDA showed moderate reliability, with the 95% CI of the ICCs (3,1) crossing 0.5. Three-way repeated measures ANOVA showed a side main effect, with asymptomatic worse, for WBLT (F = 16.9, p < 0.001) and SEBTA (F = 5.4, p = 0.03); an overall improving time main effect for SEBTPL (F = 6.9, p = 0.02). Neither a gender main effect nor any interaction effect was found. CONCLUSIONS WBLT, SEBTA and SEBTPM can be strongly recommended for measuring ankle dorsiflexion mobility and dynamic balance for both sides of individuals with unilateral CAI, while only WBLT can be used for side-to-side comparison. The application of a goniometer to measure DFROM, SEBTPL or AMEDA should be done cautiously for this specific cohort, considering their poor to good reliability for the symptomatic side.
Collapse
Affiliation(s)
- Xiaojian Shi
- School of Health Science, Swinburne University of Technology, Hawthorn, 3122, Victoria, Australia; School of Exercise and Health, Shanghai University of Sport, Shanghai, 200090, China.
| | - Charlotte Ganderton
- School of Health Science, Swinburne University of Technology, Hawthorn, 3122, Victoria, Australia; College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China; School of Biomedical Science and Health, Royal Melbourne Institute of Technology University, Bundoora, 3083, Victoria, Australia
| | - Oren Tirosh
- School of Health Science, Swinburne University of Technology, Hawthorn, 3122, Victoria, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, ACT2600, Australia
| | - Doa Ei-Ansary
- School of Biomedical Science and Health, Royal Melbourne Institute of Technology University, Bundoora, 3083, Victoria, Australia
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China; School of Exercise and Health, Shanghai University of Sport, Shanghai, 200090, China; Research Institute for Sport and Exercise, University of Canberra, ACT2600, Australia.
| |
Collapse
|
4
|
Ramalingam K, Perumal D, Balan H, Leong JF, Thiruselvam T. The Incidence of Gastrocnemius Tightness Among Clinic Staff in a District Hospital's Clinic in the State of Kedah, Malaysia. Cureus 2023; 15:e40714. [PMID: 37485103 PMCID: PMC10359758 DOI: 10.7759/cureus.40714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2023] [Indexed: 07/25/2023] Open
Abstract
Aim Musculus Gastrocnemius Tightness (MGT) has been linked with common foot and ankle pathologies. These symptoms sometimes are not severe enough for the patient to seek treatment. This study aims to determine the incidence rate of MGT among our clinical personnel and if there is any association between foot and ankle symptoms with MGT. Materials and methods This observational cross-sectional study involves clinical personnel from our Specialist Clinics at Hospital Kulim, Malaysia. We interviewed and assessed 85 volunteers of which, we measured the passive ankle dorsiflexion of the volunteers (the Silfverskiöld) test, to diagnose MGT. We then used the Manchester Oxford Foot Questionnaire (MOxFQ) is used to determine the functional outcome of our volunteers. Results Out of a total of 85 volunteers assessed, 12 (14%) volunteers were found to have gastrocnemius tightness. Among this cohort, 11 were symptomatic. Out of the 73 who did not have MGT, there were three symptomatic volunteers. There was a significant association between volunteers with foot and ankle symptoms with gastrocnemius tightness, compared to those without. There was a significant difference in the relationship between the MOxFQ scores in all components (walking, pain, and social) when comparing those with and those without MGT. Conclusion We conclude that there is a significant association between foot and ankle symptoms and MGT in our clinic sample population. However, these symptoms were not severe enough for these symptomatic volunteers to seek treatment. We should consider screening symptomatic staff and implementing stretching protocols.
Collapse
Affiliation(s)
- Kuharajan Ramalingam
- Orthopedics and Traumatology, Hospital Kulim/Kementerian Kesihatan Malaysia, Kulim, MYS
| | - Divaagar Perumal
- Orthopedics and Traumatology, Hospital Kulim/Kementerian Kesihatan Malaysia, Kulim, MYS
| | - Harswini Balan
- Orthopedics and Traumatology, Hospital Kulim/Kementerian Kesihatan Malaysia, Kulim, MYS
| | - Juzaily F Leong
- Orthopedic and Traumatology, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, MYS
| | | |
Collapse
|
5
|
Zhao Y, Zhong J, Wang Y, Chen Q, Yin J, Wang J, Zhao H, Li Y, Gong H, Huang W. Photocurable and elastic polyurethane based on polyether glycol with adjustable hardness for 3D printing customized flatfoot orthosis. Biomater Sci 2023; 11:1692-1703. [PMID: 36626200 DOI: 10.1039/d2bm01538b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Orthopedic insoles is the most commonly used nonsurgical treatment method for the flatfoot. Polyurethane (PU) plays a crucial role in the manufacturing of orthopedic insoles due to its high wear resistance and elastic recovery. However, preparing orthopedic insoles with adjustable hardness, high-accuracy, and matches the plantar morphology is challenging. Herein, a liquid crystal display (LCD) three-dimensional (3D) printer was used to prepare the customized arch-support insoles based on photo-curable and elastic polyurethane acrylate (PUA) composite resins. Two kinds of photo-curable polyurethanes (DL1000-PUA and DL2000-PUA) were successfully synthesized, and a series of fast-photocuring polyurethane acrylate (PUA) composite resins for photo-polymerization 3D printing were developed. The effects of different acrylate monomers on the Shore hardness, viscosity, and mechanical properties of the PUA composite resins were evaluated. The PUA-3-1 composite resin exhibited low viscosity, optimal hardness, and mechanical properties. A deviation analysis was conducted to assess the accuracy of printed insole. Furthermore, the stress conditions of the PUA composite resin and ethylene vinyl acetate (EVA) under the weight load of healthy adults were compared by finite element analysis (FEA) simulation. The results demonstrated that the stress of the PUA composite resin and EVA were 0.152 MPa and 0.285 MPa, and displacement were 0.051 mm and 3.449 mm, respectively. These results indicate that 3D-printed arch-support insole based on photocurable PUA composite resin are high-accuracy, and can reduce plantar pressure and prevent insoles premature deformation, which show great potential in the physiotherapeutic intervention for foot disorders.
Collapse
Affiliation(s)
- Yanyan Zhao
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
| | - Jing Zhong
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China. .,Dermatology Hospital, Southern Medical University, Guangzhou, 510091, China
| | - Yilin Wang
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
| | - Qiwei Chen
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
| | - Junfeiyang Yin
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
| | - Jiejie Wang
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
| | - Hong Zhao
- Guangdong Medical University, Zhanjiang, 524001, China
| | - Yanbing Li
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
| | - Haihuan Gong
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China. .,Department of Stomatology, Affiliated Hospital of Guangdong Medical University, Guangdong medical university, Zhanjiang, 524000, China
| | - Wenhua Huang
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China. .,Guangdong Medical University, Zhanjiang, 524001, China
| |
Collapse
|
6
|
Almansoof HS, Nuhmani S, Muaidi Q. Correlation of ankle dorsiflexion range of motion with lower-limb kinetic chain function and hop test performance in healthy male recreational athletes. PeerJ 2023; 11:e14877. [PMID: 36846443 PMCID: PMC9951801 DOI: 10.7717/peerj.14877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/20/2023] [Indexed: 02/23/2023] Open
Abstract
Background The study aims to identify the correlation of ankle dorsiflexion range-of-motion (ADROM) (with its related gastrocnemius and soleus extensibility) with lower-limb kinetic chain function and hop test performance in young healthy recreational athletes. Methods Twenty-one young male healthy recreational athletes were tested for ADROM, gastrocnemius and soleus extensibility, lower-limb kinetic chain function with the closed kinetic chain lower extremity stability test (CKCLEST) and hop test performance with the single-leg hop for distance test (SHDT) and side hop test (SHT). Results There was a positive significant (rho = 0.514, 95% CI [0.092-0.779], P < 0.01) correlation between the dominant lower-limb weight-bearing/closed-chain ADROM (that represented the soleus extensibility) and the CKCLEST. There were no significant correlations between the study performance-based tests and open-chain ADROM (P > 0.05). Conclusion The CKCLEST is positively and significantly correlated with SHT and weight-bearing ADROM with knee flexion (and its related soleus extensibility) which suggests comparability among them. Open-chain ADROM has a negligible and non-significant correlation with the readings of this study performance-based tests suggesting that it is probably not an essential construct of their execution. To the best of our knowledge, this study is the first to investigate these correlations.
Collapse
Affiliation(s)
- Haifa Saleh Almansoof
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
| | - Shibili Nuhmani
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
| | - Qassim Muaidi
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
| |
Collapse
|
7
|
Lim W. Acute effect of diagonal stretching using the posterior oblique sling system on contralateral ankle dorsiflexion. J Back Musculoskelet Rehabil 2023; 36:245-252. [PMID: 36120769 DOI: 10.3233/bmr-220073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND A significant increase in the dorsiflexion range of motion (DFROM) after calf muscle stretching has been widely studied. However, it has been shown that the upper body is connected to the ankle joint by passive connective tissues. OBJECTIVE The purpose of this study was to examine the effect of upper-back stretching on the mobility of the contralateral ankle. METHODS In the supine position, DFROM in the contralateral leg was measured. In the sitting position with and without trunk rotation, DFROM was measured in both legs. In the sitting position with trunk rotation, dorsiflexion was measured only in the contralateral leg. Static diagonal stretching combining trunk rotation with slight trunk flexion was performed in the sitting position with a neutral pelvis. RESULTS After stretching, DFROM in contralateral and ipsilateral legs were measured in the sitting position with a neutral pelvis. In the contralateral leg, significant differences in ΔDFROM were observed between the sitting position with trunk rotation and the supine position and between the sitting position with trunk rotation and the sitting position after stretching. CONCLUSION In clinical settings, diagonal stretching of the unilateral posterior trunk causes a significant increase in the DFROM of the contralateral lower limb.
Collapse
Affiliation(s)
- Wootaek Lim
- Department of Physical Therapy, College of Health and Welfare, Woosong University, 171 Dongdaejeon-ro, Dong-gu, Daejeon, Korea.,Woosong Institute of Rehabilitation Science, Woosong University, 171 Dongdaejeon-ro, Dong-gu, Daejeon, Korea
| |
Collapse
|
8
|
Adillón C, Gallegos M, Treviño S, Salvat I. Ankle Joint Dorsiflexion Reference Values in Non-Injured Youth Federated Basketball Players: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11740. [PMID: 36142013 PMCID: PMC9517286 DOI: 10.3390/ijerph191811740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/06/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: The aim of the present study was to establish ankle joint dorsiflexion reference values among youth federated basketball players. (2) Methods: Cross-sectional study. The participants were basketball players who belonged to youth basketball developmental teams (female and male) from under-12 (U12) to under-17 (U17) categories. Ankle joint dorsiflexion range of motion was evaluated with the weight-bearing lunge test through the Leg Motion system. The distance achieved was recorded in centimeters. (3) Results: 693 basketball players who met the eligibility criteria and volunteered to participate were included in the study. The mean (SD) of ankle joint dorsiflexion was 10.68 (2.44) cm and the reference values were: excessive hypomobility < 6.09 (0.54) cm; hypomobility 6.09 (0.88) cm-8.43 (0.77) cm; normal 8.44 (0.77)-13.11 (0.79) cm; hypermobility 13.11 (0.74)-15.44 (0.86) cm; and excessive hypermobility >15.44 (0.86) cm. (4) Conclusions: This study provides ankle joint dorsiflexion reference values in youth basketball players from 12 to under 17 years old.
Collapse
Affiliation(s)
- Cristina Adillón
- Faculty of Medicine and Health Sciences, Department of Medicine and Surgery, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, 43003 Tarragona, Spain
| | - Montse Gallegos
- Health Department, Catalan Basketball Federation, 08018 Barcelona, Spain
| | - Silvia Treviño
- Health Department, Catalan Basketball Federation, 08018 Barcelona, Spain
| | - Isabel Salvat
- Faculty of Medicine and Health Sciences, Department of Medicine and Surgery, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, 43003 Tarragona, Spain
| |
Collapse
|
9
|
McNab B, Sadler S, Lanting S, Chuter V. The relationship between foot and ankle joint flexibility measures and barefoot plantar pressures in healthy older adults: a cross-sectional study. BMC Musculoskelet Disord 2022; 23:729. [PMID: 35906599 PMCID: PMC9338503 DOI: 10.1186/s12891-022-05618-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Restriction in foot and ankle joint range of motion, such as an ankle equinus, has been associated with increased plantar pressure and its complications. However, previous research is limited by its scope of measures and study populations. The aim of this study was to investigate the relationship between foot and ankle joint range of motion on barefoot plantar pressures during walking in healthy older adults. METHODS This cross-sectional study recruited 49 older adults. Participants underwent measures of foot (first metatarsophalangeal dorsiflexion range of motion, and navicular drop and drift) and ankle joint range of motion, foot posture, body mass index, and plantar pressure during barefoot walking. Spearman Rank Order Correlations were used to explore the relationship between foot and ankle measures, body mass index, and plantar pressure, with significant correlations explored in a hierarchical regression analysis. A Mann-Whitney U test was performed to compare plantar pressure values between those with and without ankle equinus per region of the foot. RESULTS Mean (SD) age and BMI were 72.4 years (5.2) and 29.8 kg/m2 (5.9) respectively. A total of 32 of the 49 participants (65%) identified as female sex. Mean (SD) ankle joint range of motion was 32.7 (6.4) degrees with 17/49 (34.7%) participants classified as having an ankle equinus (defined as < 30 degrees of ankle joint dorsiflexion range of motion). We found that an ankle equinus predicted a statistically significant amount of peak forefoot plantar pressure (p = 0.03). Participants with an ankle equinus displayed significantly higher forefoot peak pressure 677.8 kPa (589.9 to 810.4) compared to those with no equinus 565.58 kPa (447.3 to 651.2), p = 0.02. A statistically significant correlation was found between body mass index and midfoot peak pressure (p < 0.01) and pressure-time integral (p < 0.01). No other significant correlations were found. CONCLUSION Clinicians should consider screening for an ankle equinus and body mass index as a simple way to identify which healthy older adults may be at risk of pressure-related complications in the mid- and forefoot.
Collapse
Affiliation(s)
- Bonnie McNab
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Central Coast Campus, 10 Chittaway Road, Ourimbah, Callaghan, NSW, 2258, Australia
| | - Sean Sadler
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Central Coast Campus, 10 Chittaway Road, Ourimbah, Callaghan, NSW, 2258, Australia.
| | - Sean Lanting
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Central Coast Campus, 10 Chittaway Road, Ourimbah, Callaghan, NSW, 2258, Australia
| | - Vivienne Chuter
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Central Coast Campus, 10 Chittaway Road, Ourimbah, Callaghan, NSW, 2258, Australia.,Discipline of Podiatry, School of Health Science, Western Sydney University, Campbelltown, NSW, Australia
| |
Collapse
|
10
|
Fischer S, Weber S, Gramlich Y, Blank M, Buckup J, Manegold S, Hoffmann R. Electrothermal Denervation of Synovial and Capsular Tissue Does not Improve Postoperative Pain in Arthroscopic Debridement of Anterior Ankle Impingement—A Prospective Randomized Study. Arthrosc Sports Med Rehabil 2022; 4:e575-e583. [PMID: 35494284 PMCID: PMC9042778 DOI: 10.1016/j.asmr.2021.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/13/2021] [Indexed: 10/25/2022] Open
|
11
|
The effects of foam rolling on ankle dorsiflexion range of motion in healthy adults: A systematic literature review. J Bodyw Mov Ther 2022; 30:53-59. [DOI: 10.1016/j.jbmt.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 01/30/2022] [Indexed: 11/20/2022]
|
12
|
Indirect Structural Muscle Injuries of Lower Limb: Rehabilitation and Therapeutic Exercise. J Funct Morphol Kinesiol 2021; 6:jfmk6030075. [PMID: 34564194 PMCID: PMC8482242 DOI: 10.3390/jfmk6030075] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022] Open
Abstract
Muscle injuries are the most common trauma in team and individual sports. The muscles most frequently affected are those of the lower limb, and in particular hamstrings, adductors, rectus femoris and calf muscles. Although several scientific studies have tried to propose different rehabilitation protocols, still too often the real rehabilitation process is not based on scientific knowledge, especially in non-elite athletes. Moreover, the growing use of physical and instrumental therapies has made it increasingly difficult to understand what can be truly effective. Therefore, the aim of the present paper is to review proposed therapeutic algorithms for muscle injuries, proposing a concise and practical summary. Following a three-phase rehabilitation protocol, this review aims to describe the conservative treatment of indirect structural muscle injuries, which are the more routinely found and more challenging type. For each phase, until return to training and return to sport are completed, the functional goal, the most appropriate practitioner, and the best possible treatment according to current evidence are expressed. Finally, the last section is focused on the specific exercise rehabilitation for the four main muscle groups with a structured explanatory timetable.
Collapse
|
13
|
Menegatti E, Masiero S, Zamboni P, Avruscio G, Tessari M, Gianesini S. Reply. J Vasc Surg Venous Lymphat Disord 2021; 9:1348-1350. [PMID: 34399940 DOI: 10.1016/j.jvsv.2021.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/11/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Erica Menegatti
- Vascular Diseases Center Unit, University of Ferrara, Ferrara, Italy
| | - Stefano Masiero
- Rehabilitation Unit, Department of Neuroscience, University of Padua, Padua, Italy
| | - Paolo Zamboni
- Vascular Diseases Center Unit, University of Ferrara, Ferrara, Italy
| | - Giampiero Avruscio
- Angiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padua University Hospital, Padua, Italy
| | - Mirko Tessari
- Vascular Diseases Center Unit, University of Ferrara, Ferrara, Italy
| | - Sergio Gianesini
- Vascular Diseases Center Unit, University of Ferrara, Ferrara, Italy; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Italy
| |
Collapse
|
14
|
Acute Effects of Gastrocnemius/Soleus Self-Myofascial Release Versus Dynamic Stretching on Closed-Chain Dorsiflexion. J Sport Rehabil 2021; 29:287-293. [PMID: 30747565 DOI: 10.1123/jsr.2018-0199] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 11/16/2018] [Accepted: 12/28/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT Limited ankle dorsiflexion (DF) range of motion has been correlated with decreased flexibility of the gastrocnemius/soleus complex. Decreased ankle DF range of motion can lead to an increase in lower-extremity injuries, for example, acute ankle sprains, Achilles tendinopathy. OBJECTIVE The purpose of this study was to determine whether a single application of the intervention to the gastrocnemius/soleus complex via multidirectional self-myofascial release using a foam roller, multiplanar dynamic stretch performed in downward dog, or a combination of both techniques acutely improved ankle DF. DESIGN Subjects were assigned to groups via random card selection. Investigators provided verbal cues as needed to yield correct performance of interventions. Both interventions were performed twice for 1 minute using a dynamic walking rest of 30.48 m at a self-selected pace between interventions. Statistical analyses were completed using a 1-way analysis of variance, at α level ≤ .05. SETTING A convenience sample study. PARTICIPANTS A total of 42 asymptomatic physical therapy students (18 females and 24 males) with mean age of 26.12 (4.03) years volunteered to participate. INTERVENTIONS Multidirectional self-myofascial release using a foam roller, multiplanar dynamic stretch performed in downward dog, or a combination of both techniques. MAIN OUTCOME MEASURES Weight-bearing right ankle DF measurements were recorded in centimeters using a forward lunge technique (intraclass correlation coefficient = .98, .97, and .96). RESULTS Data analysis revealed no significant difference between the 3 groups in all pre-post measurements (P = .82). Mean (SD) measurements from pretest to posttest for myofascial release, dynamic stretching, and combination interventions were 0.479 (0.7) cm, 0.700 (0.7) cm, and 0.907 (1.4) cm, respectively. CONCLUSION Until further studies are conducted, the selection of technique to increase ankle DF range of motion should be based on each individual patient's ability, preference, and response to treatment.
Collapse
|
15
|
Proximal medial gastrocnemius release: Muscle strength evaluation. Foot Ankle Surg 2020; 26:828-832. [PMID: 31874790 DOI: 10.1016/j.fas.2019.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/30/2019] [Accepted: 10/29/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Contracture of the gastrocnemius has been associated with different foot and ankle pathologies. The present study's aim is to evaluate the effect of the proximal medial gastrocnemius release (PMGR) in triceps surae strength. METHODS Prospective study with 14 patients (12 women; mean age 52 years). Inclusion criteria were patients undergoing PMGR due to forefoot and/or hindfoot injury with medial gastrocnemius contracture that has not improved with physical therapy. Isometric and isokinetic force evaluation tests with an isokinetic dynamometer (Con-Trex) were performed preoperatively, at 6 and 12 months postoperative, of both limbs. RESULTS After isokinetic assessment, the statistically significant difference in the preoperative isometric strength of the triceps between the two ankles was confirmed, being stronger the asymptomatic limb. An improvement in the triceps strength in isokinetics was observed at 60°/s at 6 months after surgery (p=0.008), that was maintained after one year (p=0.05). No differences were observed at 120°/sec speed. CONCLUSION Patients with gastrocnemius contracture present a decrease in isometric force with respect to the asymptomatic limb preoperatively. There is an improvement in isokinetic strength after 6 months postoperatively.
Collapse
|
16
|
Valagussa G, Balatti V, Trentin L, Piscitelli D, Yamagata M, Grossi E. Relationship between tip-toe behavior and soleus - gastrocnemius muscle lengths in individuals with autism spectrum disorders. J Orthop 2020; 21:444-448. [PMID: 32982098 PMCID: PMC7493131 DOI: 10.1016/j.jor.2020.08.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/17/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND About 20% of individuals with autism spectrum disorders (ASD) showed tip-toe behavior (TTB). This behavior may be related to a decreased ankle joint range of motion (ROM) in dorsiflexion. Physiologically, gastrocnemius (GM) and soleus (SM) muscles influence ankle ROM independently. However, no studies investigated the relationship between the amount of time individuals with ASD spend in TTB and GM and SM muscle lengths. OBJECTIVE To evaluate the relationship between three mutually exclusive clinical patterns of TTB i.e., during standing, walking and running (TTB Class 1), or during walking and running (TTB Class 2), or only when running (TTB Class 3), and GM and SM muscle lengths. METHODS Sixty-nine individuals with ASD (average age: 14.1 ± 3.6 years, 56 males) were enrolled. In a clinical setting, SM and GM muscle lengths of both legs were assessed through a manual goniometer. Measurements were performed by two trained assessors blinded to TTB classifications. RESULTS Individuals with ASD classified as TTB Class 1 demonstrated a shortening of both GM and SM compared with NO-TTB and TTB Class 3 individuals. CONCLUSIONS Our results support the relationship between TTB severity and GM and SM shortening assessed by a decreased ankle joint ROM in dorsiflexion. Further studies are needed to determine the factors associated with TTB and decreased ankle ROM.
Collapse
Affiliation(s)
- Giulio Valagussa
- Autism Research Unit, Villa Santa Maria Foundation, Via IV Novembre 15, Tavernerio, CO, Italy
- School of Medicine and Surgery, University of Milano Bicocca, Milano, Italy
- Corresponding author. Autism Research Unit, Villa Santa Maria Foundation, Tavernerio, CO, Italy.
| | - Valeria Balatti
- Autism Research Unit, Villa Santa Maria Foundation, Via IV Novembre 15, Tavernerio, CO, Italy
| | - Luca Trentin
- Autism Research Unit, Villa Santa Maria Foundation, Via IV Novembre 15, Tavernerio, CO, Italy
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano Bicocca, Milano, Italy
- School of Physical & Occupational Therapy, McGill University, Montreal, Canada
| | - Momoko Yamagata
- Faculty of Human Development, Graduate School of Human Development and Environment, Kobe University, Japan
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Enzo Grossi
- Autism Research Unit, Villa Santa Maria Foundation, Via IV Novembre 15, Tavernerio, CO, Italy
| |
Collapse
|
17
|
Gamba C, Serrano-Chinchilla P, Ares-Vidal J, Solano-Lopez A, Gonzalez-Lucena G, Ginés-Cespedosa A. Proximal Medial Gastrocnemius Release Versus Open Plantar Fasciotomy for the Surgical Treatment in Recalcitrant Plantar Fasciitis. Foot Ankle Int 2020; 41:267-274. [PMID: 31808359 DOI: 10.1177/1071100719891979] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Plantar fasciitis is a common cause of foot pain. If conservative treatment fails, there is no consensus as to the best surgical management for recalcitrant plantar fasciitis (RPF). The aim of this study was to compare the results obtained from proximal medial gastrocnemius release (PMGR) with those obtained from open plantar fasciotomy (OPF) in terms of pain, satisfaction, health-related quality of life, and American Orthopaedic Foot & Ankle Society (AOFAS) score. METHODS This is a prospective randomized trial conducted between 2012 and 2016. Patients with RPF for at least 9 months were included. Diagnosis was clinically made. The exclusion criteria were neuropathic heel pain; a history of previous foot fracture, surgery, or deformity; rheumatoid arthritis; or the need for long-term analgesic administration. After ruling out other conditions with magnetic resonance or ultrasound imaging, patients were randomized to be operated on with OPF or PMGR independently of the Silfverskjold test. Follow-up was carried out for up to 1 year. The AOFAS, visual analog scale (VAS) for pain, SF-36, and Likert scale for satisfaction were used to evaluate the results obtained. The analysis was done with 21 patients in the OPF group and 15 in the PMGR group. The demographic data (age, sex, body mass index, duration of symptoms, and positivity to the Silfverskjold test) of the groups were comparable. RESULTS No differences were found in terms of the AOFAS (P = .24), VAS (P = .14), or any item of the SF-36. Satisfaction was very good in 85.8% of the PMGR group and 89.5% of the OPF group (P = .27). Faster recovery was observed in the PMGR group. CONCLUSION OPF and PMGR provided good results for patients with RPF. Neither was superior to the other relative to pain, AOFAS score, satisfaction, or the SF-36. We recommend PMGR as the first option in RPF surgical management in order to avoid potential biomechanical complications related to OPF. LEVEL OF EVIDENCE Level I, therapeutic randomized controlled trial.
Collapse
Affiliation(s)
- Carlo Gamba
- Orthopaedic Department, Hospital del Mar, Universitat Autonoma Barcelona (UAB), Barcelona, Spain.,Orthopaedic Department, Hospital de la Santa Creu I Sant Pau, Universitat Autonoma Barcelona (UAB), Barcelona, Spain
| | | | - Jesus Ares-Vidal
- Department of Radiology and Radiodiagnostic, Hospital del Mar, Barcelona, Spain
| | | | - Gemma Gonzalez-Lucena
- Orthopaedic Department, Hospital del Mar, Universitat Autonoma Barcelona (UAB), Barcelona, Spain
| | - Alberto Ginés-Cespedosa
- Orthopaedic Department, Hospital del Mar, Universitat Autonoma Barcelona (UAB), Barcelona, Spain
| |
Collapse
|
18
|
Affiliation(s)
| | - Ka Ho Ng
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong
| | - Joyce Lai
- Department of Family Medicine and Primary Care, Queen Mary Hospital, Hong Kong
| |
Collapse
|
19
|
Bisciotti GN, Volpi P, Alberti G, Aprato A, Artina M, Auci A, Bait C, Belli A, Bellistri G, Bettinsoli P, Bisciotti A, Bisciotti A, Bona S, Bresciani M, Bruzzone A, Buda R, Buffoli M, Callini M, Canata G, Cardinali D, Cassaghi G, Castagnetti L, Clerici S, Corradini B, Corsini A, D'Agostino C, Dellasette E, Di Pietto F, Enrica D, Eirale C, Foglia A, Franceschi F, Frizziero A, Galbiati A, Giammatei C, Landreau P, Mazzola C, Moretti B, Muratore M, Nanni G, Niccolai R, Orizio C, Pantalone A, Parra F, Pasta G, Patroni P, Pelella D, Pulici L, Quaglia A, Respizzi S, Ricciotti L, Rispoli A, Rosa F, Rossato A, Sannicandro I, Sprenger C, Tarantola C, Tenconi FG, Tognini G, Tosi F, Trinchese GF, Vago P, Zappia M, Vuckovich Z, Zini R, Trainini M, Chamari K. Italian consensus statement (2020) on return to play after lower limb muscle injury in football (soccer). BMJ Open Sport Exerc Med 2019; 5:e000505. [PMID: 31673400 PMCID: PMC6797382 DOI: 10.1136/bmjsem-2018-000505] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2019] [Indexed: 12/19/2022] Open
Abstract
Return to play (RTP) decisions in football are currently based on expert opinion. No consensus guideline has been published to demonstrate an evidence-based decision-making process in football (soccer). Our aim was to provide a framework for evidence-based decision-making in RTP following lower limb muscle injuries sustained in football. A 1-day consensus meeting was held in Milan, on 31 August 2018, involving 66 national and international experts from various academic backgrounds. A narrative review of the current evidence for RTP decision-making in football was provided to delegates. Assembled experts came to a consensus on the best practice for managing RTP following lower limb muscle injuries via the Delphi process. Consensus was reached on (1) the definitions of 'return to training' and 'return to play' in football. We agreed on 'return to training' and RTP in football, the appropriate use of clinical and imaging assessments, and laboratory and field tests for return to training following lower limb muscle injury, and identified objective criteria for RTP based on global positioning system technology. Level of evidence IV, grade of recommendation D.
Collapse
Affiliation(s)
| | - Piero Volpi
- Humanitas Clinical Institute, Rozzano, Milano, Italy.,FC Internazionale Milano, Milano, Milano, Italy
| | - Giampietro Alberti
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | | | | | - Alessio Auci
- UOS Angiografia e Radiologia Interventistica, Ospedale delle Apuane, Massa Carrara, Massa Carrara, Italy
| | | | | | | | | | | | | | - Stefano Bona
- Humanitas Clinical Institute, Rozzano, Milano, Italy
| | | | | | - Roberto Buda
- Dipartimento di Scienze Biomediche e Neuromotorie, Università Bologna, Bologna, Italy
| | | | | | - Gianluigi Canata
- Ospedale Koelliker, Torino, Italy.,Istituto di Medicina dello Sport di Torino, Torino, Italy
| | | | | | | | | | | | | | | | | | | | | | - Cristiano Eirale
- Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Paris St Germain FC, Paris, France
| | - Andrea Foglia
- Physiotherapy, Studio Riabilita, Civitanova Marche, Italy
| | | | | | | | | | | | | | - Biagio Moretti
- Dipartimento di Scienze Mediche di Base, Neuroscienze e Organi di Senso, Università di Bari, Bari, Italy
| | | | - Gianni Nanni
- FIFA Medical Centre of Excellence, Bologna, Isokinetic Medical Group, Bologna, Italy.,Bologna FC, Bologna, Italy
| | | | | | - Andrea Pantalone
- Universita degli Studi Gabriele d'Annunzio Chieti e Pescara, Chieti, Italy.,Ospedale SS Annunziata, Chieti, Italy
| | | | - Giulio Pasta
- Parma Calcio, Parma, Italy.,Studio Radiologico Pasta, Parma, Italy
| | | | | | - Luca Pulici
- FC Internazionale Milano, Milano, Milano, Italy
| | - Alessandro Quaglia
- Humanitas Clinical Institute, Rozzano, Milano, Italy.,FC Internazionale Milano, Milano, Milano, Italy
| | | | | | | | | | | | | | | | | | | | | | - Fabio Tosi
- FC Internazionale Milano, Milano, Milano, Italy
| | | | - Paola Vago
- Universita Cattolica del Sacro Cuore, Milano, Italy
| | | | | | - Raul Zini
- Villa Maria Cecilia, Cotignola, Italy
| | | | - Karim Chamari
- Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Research Lab, National Center of Science and Sports Medicine Tunis, Tunis, Tunisia
| |
Collapse
|
20
|
Chan O, Malhotra K, Buraimoh O, Cullen N, Welck M, Goldberg A, Singh D. Gastrocnemius tightness: A population based observational study. Foot Ankle Surg 2019; 25:517-522. [PMID: 30321953 DOI: 10.1016/j.fas.2018.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 03/17/2018] [Accepted: 04/03/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Gastrocnemius tightness is believed to be associated with multiple musculoskeletal pathologies such as back pain, plantar fasciitis and metatarsalgia. Although surgical treatment of gastrocnemius tightness is gaining popularity the objective definition of a gastrocnemius contracture has not been determined. The aim of our study was therefore to quantify gastrocnemius tightness in a normal population. METHODS Adult participants with no obvious foot and ankle pathology were recruited. Gastrocnemius tightness was quantified using a weightbearing lunge test. Maximal ankle-foot dorsiflexion was measured on participants with the knee in full extension and flexed to 20° using a digital inclinometer. The ankle-foot dorsiflexion index or ADI (difference in ankle dorsiflexion with the knee extended and flexed) was calculated. The ADI values were plotted on a histogram to identify the distribution of values and were compared according to participant demographics. RESULTS 800 limbs from 400 participants were examined. There was a wide distribution of absolute values of maximal ankle-foot dorsiflexion ranging from 8 to 52°. The ADI ranged from 0 to19° and approximated to a normal distribution. The mean ADI was 6.04±3.49° and was positively correlated with age (r=0.132, P<0.001) and negatively correlated with physical activity (r=-0.88, P=0.015). CONCLUSION(S) Our study is the first to quantify gastrocnemius tightness in a large healthy adult population with differences observed by age and physical activity. We have defined an easy and reproducible weightbearing test that can be used in both research and clinical settings. The majority of the population have some degree of gastrocnemius tightness and values of ADI greater than 13° (>2 SD of the mean), as measured by the lunge test, may be considered abnormal.
Collapse
Affiliation(s)
- Oliver Chan
- Foot & Ankle Unit, Royal National Orthopaedic Hospital, Stanmore HA7 4LP, United Kingdom.
| | - Karan Malhotra
- Foot & Ankle Unit, Royal National Orthopaedic Hospital, Stanmore HA7 4LP, United Kingdom
| | - Olatunbosun Buraimoh
- Foot & Ankle Unit, Royal National Orthopaedic Hospital, Stanmore HA7 4LP, United Kingdom
| | - Nick Cullen
- Foot & Ankle Unit, Royal National Orthopaedic Hospital, Stanmore HA7 4LP, United Kingdom
| | - Matthew Welck
- Foot & Ankle Unit, Royal National Orthopaedic Hospital, Stanmore HA7 4LP, United Kingdom
| | - Andy Goldberg
- Foot & Ankle Unit, Royal National Orthopaedic Hospital, Stanmore HA7 4LP, United Kingdom
| | - Dishan Singh
- Foot & Ankle Unit, Royal National Orthopaedic Hospital, Stanmore HA7 4LP, United Kingdom
| |
Collapse
|
21
|
Searle MOsteo A, Spink MJ, Chuter VH. Validation of a weight bearing ankle equinus value in older adults with diabetes. J Foot Ankle Res 2018; 11:62. [PMID: 30479667 PMCID: PMC6249959 DOI: 10.1186/s13047-018-0306-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 11/05/2018] [Indexed: 12/13/2022] Open
Abstract
Background Accurate measurement of ankle joint dorsiflexion is clinically important as a restriction has been linked to many foot and ankle pathologies, as well as increased ulcer risk and delayed ulcer healing in people with diabetes. Use of the reliable weight bearing (WB) Lunge test is limited as normal and restricted ranges for WB ankle joint dorsiflexion are not identified. Additionally the extent of WB dorsiflexion restriction that results in clinically adverse outcomes is unclear. Therefore the aim of this investigation is to validate a proposed weight bearing equinus value (dorsiflexion < 30°) in unimpaired cohorts, and secondly to investigate any clinical effects this degree of ankle dorsiflexion restriction has on forefoot plantar pressure variables in older adults with diabetes. Methods Ankle dorsiflexion was measured using a Lunge test with the knee extended in young adults without diabetes (YA) and older adults with diabetes (DA). In-shoe and barefoot plantar pressure was recorded for the DA group. Spearman’s correlation was calculated to determine any association between the presence of ankle equinus and plantar pressure variables in the DA group. DA group differences in people with and without an equinus were examined. Results A weight bearing equinus of < 30°, assessed in a lunge using an inclinometer placed on the anterior tibia, falls within the restricted range in young unimpaired cohorts. In the DA group this degree of ankle restriction had a fair and significant association with elevated barefoot forefoot peak pressure (r = 0.274, p = 0.005) and pressure-time integrals (r = 0.321, p = .001). The DA equinus group had significantly higher barefoot peak pressure (mean kPa (SD): 787.1 (246.7) vs 652.0 (304.5), p = 0.025) and pressure-time integrals (mean kPa (SD): 97.8 (41.6) vs 80.4 (30.5), p = 0.017) than the DA non equinus group. Conclusions We support a preliminary weight bearing ankle equinus value of < 30°. This value represents a restricted range in young adults and is correlated with increased forefoot plantar pressure variables in older adults with diabetes. Mean population weight bearing ankle dorsiflexion data presented here for older adults with diabetes, will allow use of the more functional Lunge test with knee extended in research and clinical practice.
Collapse
Affiliation(s)
- A Searle MOsteo
- 1School of Health Sciences, Faculty of Health, University of Newcastle, PO Box 127, Ourimbah, NSW 2258 Australia
| | - M J Spink
- 1School of Health Sciences, Faculty of Health, University of Newcastle, PO Box 127, Ourimbah, NSW 2258 Australia
| | - V H Chuter
- 1School of Health Sciences, Faculty of Health, University of Newcastle, PO Box 127, Ourimbah, NSW 2258 Australia.,2Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, PO Box 127, Ourimbah, NSW 2258 Australia
| |
Collapse
|
22
|
Malhotra K, Chan O, Cullen S, Welck M, Goldberg AJ, Cullen N, Singh D. Prevalence of isolated gastrocnemius tightness in patients with foot and ankle pathology. Bone Joint J 2018; 100-B:945-952. [DOI: 10.1302/0301-620x.100b7.bjj-2017-1465.r1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Aims Gastrocnemius tightness predisposes to musculoskeletal pathology and may require surgical treatment. However, it is not clear what proportion of patients with foot and ankle pathology have clinically significant gastrocnemius tightness. The aim of this study was to compare the prevalence and degree of gastrocnemius tightness in a control group of patients with a group of patients with foot and ankle pathology. Patients and Methods This prospective, case-matched, observational study compared gastrocnemius tightness, as assessed by the lunge test, in a control group and a group with foot and ankle pathology. Gastrocnemius tightness was calculated as the difference in dorsiflexion of the ankle with the knee extended and flexed. Results A total of 291 controls were paired with 97 patients with foot and ankle pathology (FAP). The mean gastrocnemius tightness was 6.0° (sd 3.5) in controls and 8.0° (sd 5.7) in the FAP group (p < 0.001). Subgroup analysis showed a mean gastrocnemius tightness of 10.3° (sd 6.0) in patients with forefoot pathology versus 6.9° (sd 5.3) in patients with other pathology (p = 0.008). A total of 12 patients (37.5%) with forefoot pathology had gastrocnemius tightness of > two standard deviations of the control group (> 13°). Conclusion Gastrocnemius tightness of > 13° may be considered abnormal. Most patients with foot and ankle pathology do not have abnormal degrees of gastrocnemius tightness compared with controls, but it is present in over a third of patients with forefoot pathology. Cite this article: Bone Joint J 2018;100-B:945–52.
Collapse
Affiliation(s)
- K. Malhotra
- Foot and Ankle Unit, Royal National Orthopaedic
Hospital, Stanmore, UK
| | - O. Chan
- Foot and Ankle Unit, Royal National Orthopaedic
Hospital, Stanmore, UK
| | - S. Cullen
- University College London Medical School, London, UK
| | - M. Welck
- Foot and Ankle Unit, Royal National Orthopaedic
Hospital, Stanmore, UK
| | - A. J. Goldberg
- Foot and Ankle Unit, Royal National Orthopaedic
Hospital, Stanmore, UK
| | - N. Cullen
- Foot and Ankle Unit, Royal National Orthopaedic
Hospital, Stanmore, UK
| | - D. Singh
- Foot and Ankle Unit, Royal National Orthopaedic
Hospital, Stanmore, UK
| |
Collapse
|
23
|
Searle A, Spink MJ, Chuter VH. Weight bearing versus non-weight bearing ankle dorsiflexion measurement in people with diabetes: a cross sectional study. BMC Musculoskelet Disord 2018; 19:183. [PMID: 29859538 PMCID: PMC5985059 DOI: 10.1186/s12891-018-2113-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/25/2018] [Indexed: 11/29/2022] Open
Abstract
Background Accurate measurement of ankle dorsiflexion is important in both research and clinical practice as restricted motion has been associated with many foot pathologies and increased risk of ulcer in people with diabetes. This study aimed to determine the level of association between non-weight bearing versus weight bearing ankle dorsiflexion in adults with and without diabetes, and to evaluate the reliability of the measurement tools. Methods One hundred and thirty-six adults with diabetes and 30 adults without diabetes underwent ankle dorsiflexion measurement non-weight bearing, using a modified Lidcombe template, and weight bearing, using a Lunge test. Pearson product-moment correlation coefficients, intraclass correlation coefficients (ICCs) with 95% confidence intervals, standard error of measurement and minimal detectable change were determined. Results There was a moderate correlation (r = 0.62–0.67) between weight and non-weight bearing tests in the non-diabetes group, and a negligible correlation in the diabetes group(r = 0.004–0.007). Intratester reliability was excellent in both groups for the modified Lidcombe template (ICC = 0.89–0.94) and a Lunge test (ICC = 0.83–0.89). Intertester reliability was also excellent in both groups for the Lidcombe template (ICC = 0.91) and a Lunge test (ICC = 0.88–0.93). Conclusions We found the modified Lidcombe template and a Lunge test to be reliable tests to measure non-weight bearing and weight bearing ankle dorsiflexion in adults with and without diabetes. While both methods are reliable, further definition of weight bearing ankle dorsiflexion normative ranges may be more relevant for clinical practice.
Collapse
Affiliation(s)
- A Searle
- School of Health Sciences, Faculty of Health, University of Newcastle, PO Box 127, Ourimbah, NSW, 2258, Australia.
| | - M J Spink
- School of Health Sciences, Faculty of Health, University of Newcastle, PO Box 127, Ourimbah, NSW, 2258, Australia
| | - V H Chuter
- School of Health Sciences, Faculty of Health, University of Newcastle, PO Box 127, Ourimbah, NSW, 2258, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, 2308, Australia
| |
Collapse
|
24
|
Daniilidis K, Jakubowitz E, Thomann A, Ettinger S, Stukenborg-Colsman C, Yao D. Does a foot-drop implant improve kinetic and kinematic parameters in the foot and ankle? Arch Orthop Trauma Surg 2017; 137:499-506. [PMID: 28220261 DOI: 10.1007/s00402-017-2652-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Unlike the drop foot therapy with ortheses, the therapeutic effect of an implantable peroneus nerve stimulator (iPNS) is not well described. IPNS is a dynamic therapy option which is placed directly to the motoric part of the peroneal nerve and evokes a dorsiflexion of the paralysed foot. This retrospective study evaluates the kinematics and kinetics in drop foot patients who were treated with an iPNS. MATERIALS AND METHODS 18 subjects (mean age 51.3 years) with a chronic stroke-related drop foot were treated with an implantable peroneal nerve stimulator. After a mean follow-up from 12.5 months, kinematics and kinetics as well as spatiotemporal parameters were evaluated and compared in activated and deactivated iPNS. Therefore, a gait analysis with motion capture system (Vicon Motion System Ltd®, Oxford, UK) and Plug-in-Gait model was performed. RESULTS The study showed significantly improved results in ankle dorsiflexion from 6.8° to 1.8° at the initial contact and from -7.3° to 0.9° during swing phase (p ≤ 0.004 and p ≤ 0.005, respectively). Likewise, we could measure improved kinetics, i.a. with a statistically significant improvement in vertical ground reaction force at loading response from 99.76 to 106.71 N/kg (p = 0.043). Enhanced spatiotemporal results in cadence, douple support, stride length, and walking speed could also be achieved, but without statistical significance (p > 0.05). CONCLUSIONS The results show statistically significant improvement in ankle dorsiflexion and vertical ground reaction forces. These facts indicate a more gait stability and gait efficacy. Therefore, the use of an iPNS appears an encouraging therapeutic option for patients with a stroke-related drop foot.
Collapse
Affiliation(s)
| | - Eike Jakubowitz
- Laboratory for Biomechanics and Biomaterials (LBB), Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625, Hanover, Germany
| | - Anna Thomann
- Laboratory for Biomechanics and Biomaterials (LBB), Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625, Hanover, Germany
| | - Sarah Ettinger
- Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625, Hanover, Germany
| | - Christina Stukenborg-Colsman
- Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625, Hanover, Germany
| | - Daiwei Yao
- Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625, Hanover, Germany
| |
Collapse
|