1
|
Shen B, Zhang S, Cui K, Zhang X, Fu W. Effects of a 12-week gait retraining program combined with foot core exercise on morphology, muscle strength, and kinematics of the arch: A randomized controlled trial. Front Bioeng Biotechnol 2022; 10:1022910. [PMID: 36299287 PMCID: PMC9589891 DOI: 10.3389/fbioe.2022.1022910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/20/2022] [Indexed: 11/27/2022] Open
Abstract
Objective: This study aims to explore the effects of a 12-week gait retraining program combined with foot core exercise on arch morphology, arch muscles strength, and arch kinematics. Methods: A total of 26 male recreational runners with normal arch structure who used rear-foot running strike (RFS) were divided into the intervention group (INT group) and control group (CON group) (n = 13 in each group). The INT group performed a 12-week forefoot strike (FFS) training combined with foot core exercises. The CON group did not change the original exercise habit. Before and after the intervention, the arch morphology, as well as the strength of hallux flexion, lesser toe flexion, and the metatarsophalangeal joint (MPJ) flexors were measured in a static position, and changes in the arch kinematics during RFS and FFS running were explored. Results: After a 12-week intervention, 1) the normalized navicular height increased significantly in the INT group by 5.1% (p = 0.027, Cohen’s d = 0.55); 2) the hallux absolute flexion and relative flexion of the INT group increased significantly by 20.5% and 21.7%, respectively (p = 0.001, Cohen’s d = 0.59; p = 0.001, Cohen’s d = 0.73), the absolute and relative strength of the MPJ flexors of the INT group were significantly improved by 30.7% and 32.5%, respectively (p = 0.006, Cohen’s d = 0.94; p = 0.006, Cohen’s d = 0.96); 3) and during RFS, the maximum arch angle of the INT group declined significantly by 5.1% (p < 0.001, Cohen’s d = 1.49), the arch height at touchdown increased significantly in the INT group by 32.1% (p < 0.001, Cohen’s d = 1.98). Conclusion: The 12-week gait retraining program combined with foot core exercise improved the arch in both static and dynamic positions with a moderate to large effect size, demonstrating the superiority of this combined intervention over the standalone interventions. Thus, runners with weak arch muscles are encouraged to use this combined intervention as an approach to enhance the arch.
Collapse
Affiliation(s)
- Bin Shen
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Shen Zhang
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
- *Correspondence: Shen Zhang,
| | - Kedong Cui
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Xini Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Weijie Fu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
| |
Collapse
|
2
|
Kim Y, Bhatia D, Lee Y, Ryu Y, Park HS. Development and Clinical Evaluation of a Novel Foot Stretching Robot that Simultaneously Stretches Plantar Fascia and Achilles Tendon for Treatment of Plantar Fasciitis. IEEE Trans Biomed Eng 2022; 69:2628-2637. [PMID: 35171762 DOI: 10.1109/tbme.2022.3151871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This paper presents the development and clinical evaluation of a foot stretching robot that simultaneously stretches the plantar fascia and Achilles tendon for the treatment of plantar fasciitis. The therapeutic effectiveness of the robot and feasibility of using metatarsophalangeal joint stiffness as an indicator of recovery were identified through the clinical evaluations. METHODS The robot implements an effective foot stretching protocol through a novel mechanism design that simultaneously stretches the plantar fascia and Achilles tendon using a single motor. Thirty patients with plantar fasciitis and fifteen healthy participants volunteered in the cross-sectional clinical evaluation, and nine patients from the patients group participated in the one-month clinical trial. Four main outcomes (Foot Function Index, Visual Analogue Scale-Foot and Ankle, plantar fascia thickness, and metatarsophalangeal joint stiffness) were used for the clinical evaluations. RESULTS In the cross-sectional clinical evaluation, the symptomatic feet of patients showed moderate negative correlation between normalized metatarsophalangeal joint stiffness and plantar fascia thickness with statistical significance. In the one-month clinical trial, all the main outcomes showed significant improvement after using the developed robot. Comparing our results with previous studies also indicated a therapeutic superiority of our robot for treating plantar fasciitis. CONCLUSION Our foot stretching robot had significant therapeutic effect on plantar fasciitis, and normalized metatarsophalangeal joint stiffness measured by our robot could be used as a monitoring indicator for recovery from plantar fasciitis. SIGNIFICANCE This study contributed to practical issues related to treatment of plantar fasciitis, and our results could be applied to effective treatment of plantar fasciitis and progressive monitoring of recovery.
Collapse
|
3
|
Jia SW, Lam WK, Huang Z, Baker JS, Ugbolue UC, Gu Y. Influence of metatarsophalangeal joint stiffness on take-off performances and lower-limb biomechanics in jump manoeuvres. J Sports Sci 2022; 40:638-645. [PMID: 35083953 DOI: 10.1080/02640414.2021.2010412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Forefoot and toes are prominent regions for locomotion and individual metatarsophalangeal joint (MTPJ) stiffness may be linked to jump take-off mechanics and performances. However, little is known about the relationships between MTPJ stiffness and take-off related variables. This study examined the relationship between individual MTPJ stiffness and biomechanical variables under various vertical countermovement jumps (CMJ) conditions. We measured MTPJ stiffness on 21 male university basketball players and then asked them to perform jumps under single, consecutive and running CMJ conditions. Pearson's correlation coefficient was employed to examine the relationships between MTP passive stiffness and each jumping performance, ground reaction force (GRF) and joint kinematic and kinetic variables. The results indicated that MTPJ stiffness significantly correlated with maximum jump height (r = 0.49, moderate), peak take-off velocity (r = 0.47, moderate), peak take-off ankle plantarflexion moment (r = 0.68, strong), peak dorsiflexion moment (r = 0.60, strong) and peak take-off ankle power (r = 0.44, moderate) in consecutive CMJ. Only a moderate correlation between MTPJ stiffness and peak MTPJ extension take-off velocity (r = -0.46, moderate) was determined in a single CMJ. There were no significant correlations found in running CMJ conditions. These findings imply that higher MTPJ stiffness of participants was related to improved jump performances in consecutive jumps.
Collapse
Affiliation(s)
- Sheng-Wei Jia
- Guangdong Provincial Engineering Technology Research Center for Sports Assistive Devices, Guangzhou Sport University, Guangzhou, China.,Faculty of Sports Science, Ningbo University, Ningbo, China.,Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Company Limited, Beijing, China
| | - Wing-Kai Lam
- Guangdong Provincial Engineering Technology Research Center for Sports Assistive Devices, Guangzhou Sport University, Guangzhou, China.,Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Company Limited, Beijing, China.,Department of Kinesiology, Shenyang Sport University, Shenyang, China
| | - Zhiguan Huang
- Guangdong Provincial Engineering Technology Research Center for Sports Assistive Devices, Guangzhou Sport University, Guangzhou, China
| | - Julien S Baker
- Faculty of Sports Science, Ningbo University, Ningbo, China.,School of Health and Life Sciences, Institute for Clinical Exercise & Health Science, University of the West of Scotland, Scotland, UK.,Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Ukadike C Ugbolue
- Faculty of Sports Science, Ningbo University, Ningbo, China.,School of Health and Life Sciences, Institute for Clinical Exercise & Health Science, University of the West of Scotland, Scotland, UK
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
| |
Collapse
|
4
|
Leow Y, Kong PW, Liu Y, Pan JW, Fong DTP, Chan CC, Heng ML. Test-retest reliability of a clinical foot assessment device for measuring first metatarsophalangeal joint quasi-stiffness. Foot (Edinb) 2020; 45:101742. [PMID: 33022579 DOI: 10.1016/j.foot.2020.101742] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/24/2020] [Accepted: 08/29/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND The stiffness of the first metatarsophalangeal joint (MTPJ) is of interest in cases such as hallux rigidus and apropulsive gait. Subjective rating of joint mobility as 'hypermobile, normal, or stiff' is an unreliable method. Previous instruments for the assessment of first MTPJ stiffness can be too hard and uncomfortable for test subjects. Recently, a new device using a load cell and optical fiber with fiber Bragg grating (FBG) sensors was developed to provide a comfortable means of clinical foot assessment. This study aimed to evaluate the test-retest reliability of this FBG-load cell device in measuring the first MTPJ quasi-stiffness. METHODS The left foot of 13 female subjects were measured twice for their first MTPJ quasi-stiffness, approximately seven days apart. The FBG-load cell device measured the MTPJ range of motion from a resting position to maximum dorsiflexion and then returning to the resting start-position. The force applied by a clinician to displace the toe was simultaneously recorded using the load cell. The quasi-stiffness over the "working range" in loading and unloading directions were determined from the slope of the torque-angular displacement graph. The test-retest reliability of the MTPJ quasi-stiffness was evaluated using intra-class correlation coefficient [ICC (2,1)]. RESULTS The reliability was almost perfect for MTPJ quasi-stiffness over the loading phase (ICC = 0.814), moderate for MTPJ quasi-stiffness over the unloading phase (ICC = 0.477) and moderate for MTPJ maximum range (ICC = 0.486). CONCLUSION The foot assessment device comprising FBG and load cell was able to reliably measure the first MTPJ quasi-stiffness in a clinical setting. The measurement reliability was higher during the loading phase than the unloading phase.
Collapse
Affiliation(s)
- Yixuan Leow
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, 639798, Singapore.
| | - Pui W Kong
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, 637616, Singapore.
| | - Yimin Liu
- School of Chemical and Biomedical Engineering, Nanyang Technological University, 639798, Singapore.
| | - Jing W Pan
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, 637616, Singapore.
| | - Daniel T P Fong
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom.
| | - Chi C Chan
- Sino-German College of Intelligent Manufacturing, Shenzhen Technology University, China.
| | - Marabelle L Heng
- Podiatry Department, Singapore General Hospital, Diabetes & Metabolism Centre, 168752, Singapore; School of Allied Health & Human Performance, University of South Australia, SA 5001, Australia.
| |
Collapse
|
5
|
Reliability and validity of an enhanced paper grip test; A simple clinical test for assessing lower limb strength. Gait Posture 2020; 81:120-125. [PMID: 32711330 DOI: 10.1016/j.gaitpost.2020.07.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/06/2020] [Accepted: 07/14/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The paper-grip-test (PGT) involves pulling a small card from underneath the participant's foot while asking them to grip with their hallux. The PGT is shown to be effective in detecting foot muscle-weakening but its outcome is operator-dependent. To overcome this limitation, an enhanced PGT (EPGT) is proposed that replaces the pass/fail outcome of the PGT with a continuous measurement of the pulling force that is needed to remove the card (EPGT-force). RESEARCH QUESTION Is the EPGT-force an accurate, reliable and clinically applicable measurement of strength? METHODS Reliability and clinical applicability were examined in two ways. Firstly, two examiners measured EPGT-force for twenty healthy volunteers in a test/retest set-up. EPGT force was measured using a dynamometer, the hallux grip force was measured using a pressure mat. The clinical applicability of the EPGT was tested in ten people with diabetes. Postural sway was also measured. RESULTS Interclass correlation coefficients (ICC) revealed excellent inter-rater reliability (ICC > 0.75). Intra-rater reliability was excellent for the first examiner (ICC = 0.795) and good for the second (ICC = 0.703). Linear regression analysis indicated that hallux grip force accounted (on average) for 83 %±4 % of the variability in EPGT force. This strong relationship between EPGT force and hallux grip force remained when the test was performed in a clinical setting with the latter accounting for 88 % in EPGT force variability. Spearman rank order correlation showed that people with diabetes with a higher difference in EPGT force between limbs swayed more. SIGNIFICANCE EPGT force is a reliable and accurate measurement of hallux grip force. Hallux grip force was previously found to be strongly correlated to the strength of all muscle groups of the foot and ankle and to the ability to maintain balance. The proposed EPGT could be used to monitor muscle weakness in clinics for better falls-risk assessment.
Collapse
|
6
|
Influence of Sport Type on Metatarsophalangeal and Ankle Joint Stiffness and Hopping Performance. JOURNAL OF HEALTHCARE ENGINEERING 2020; 2020:9025015. [PMID: 32257087 PMCID: PMC7097758 DOI: 10.1155/2020/9025015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 02/12/2020] [Accepted: 02/18/2020] [Indexed: 11/18/2022]
Abstract
While individual ankle and metatarsophalangeal joint stiffness is related to training intensity and sport performances, sport athletes may develop specific passive joint stiffness among the spectrum from endurance to powerful types of sports. The objective of this study examined whether marathon runners, basketball players, and other sports athletes would demonstrate distinct passive ankle and metatarsophalangeal joint stiffness as well as vertical stiffness. Fifteen marathon runners, nineteen basketball players, and seventeen other sports athletes performed both joint stiffness measurement and single-leg hopping tests. We used a computerized dynamometer to control foot alignment and speed for passive ankle and metatarsophalangeal joint stiffness measurements. We calculated vertical stiffness by body deceleration and body mass displacement during hopping on the force platform. One-way ANOVA was performed to identify the group differences. Bivariate correlation test was also performed among ankle, metatarsophalangeal, and vertical stiffness. The basketball group displayed 13% higher ankle passive stiffness than the other sports players group (P = 0.03). Metatarsophalangeal joint passive stiffness in sitting and standing positions was 23% higher in the basketball group than the runner and other sports athlete groups (P < 0.01). However, there was no significant group differences in metatarsophalangeal joint passive stiffness and vertical stiffness. Significant correlations among all stiffness variables were determined (P < 0.05). These findings indicate that ankle and metatarsophalangeal joint passive stiffness, rather than vertical leg stiffness, would be in relation to types of sports participation. Ankle and toe strengthening exercises could improve basketball players' performance and prevent injury.
Collapse
|
7
|
Farhadi F, Faraz M, Heng M, Johnson S. An Ergonomic Testing System for the First Metatarsophalangeal Joint Stiffness. J Biomech Eng 2018; 140:2681671. [PMID: 30029238 DOI: 10.1115/1.4040248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Indexed: 11/08/2022]
Abstract
Osteoarthritis sufferers commonly have first metatarsophalangeal joint (MTPJ) problems in which articular surfaces are changed permanently due to fatigue. Therefore, medical devices for early diagnosis would increase the opportunity for prevention of disease progression. In previous studies on stiffness of the first MTPJ many details, although functionally of great importance, have not been fully considered including: design and size of the device, tribology consideration, and errors from device. Therefore, the motivation of our research was to enhance the device design by reducing the size of the device, and device design was enhanced by minimizing measurement errors through development of a new ergonomic left and right foot instrument located medial to the first MTPJ (instead of beneath the foot). The first MTPJ stiffness (N mm/kg radian) measurement was taken on 28 subjects with two replicates per subject by the same tester. The first MTPJ stiffness ranged from 3.49 to 14.42 N mm/kg radian with the mean (SD) value of 8.28 (3.15) N mm/kg radian for the left feet and 3.91 to 11.90 N mm/kg radian with the mean (SD) value of 7.65 (2.07) N mm/kg radian for the right feet. Reliability evaluation was measured using intraclass correlation coefficient and described an excellent reliability between two tests.
Collapse
Affiliation(s)
- Fatemeh Farhadi
- University of Michigan and Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Muhammad Faraz
- University of Michigan and Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Marabelle Heng
- Podiatry Department, Diabetes and Metabolism Centre, Singapore General Hospital, 17 Third Hospital Avenue, Singapore 168752
| | - Shane Johnson
- University of Michigan and Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China.,State Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai 200240, China e-mail:
| |
Collapse
|