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Barsante LD, Arantes PMM, Vaz DV, Magalhães FA, Carvalho DS, Cruz AC, Resende RA, Ocarino JM, Fonseca ST, Souza TR. The Midfoot Joint Complex (Foot Arch) Contributes to the Upper Body Position in Bipedal Walking and Coordinates With the Lower Limb Joints. J Appl Biomech 2024; 40:241-249. [PMID: 38604601 DOI: 10.1123/jab.2023-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 12/04/2023] [Accepted: 02/27/2024] [Indexed: 04/13/2024]
Abstract
This study estimated the contribution of the midfoot joint complex (MJC) kinematics to the pelvis anterior-posterior positions during the stance phase of walking and investigated whether the MJC is functionally coordinated with the lower limb joints to maintain similar pelvic positions across steps. Hip, knee, ankle, and MJC sagittal angles were measured in 11 nondisabled participants during walking. The joints' contributions to pelvic positions were computed through equations derived from a link-segment model. Functional coordination across steps was identified when the MJC contribution to pelvic position varied and the summed contributions of other joints varied in the opposite direction (strong negative covariations [r ≤ -.7] in stance phase instants). We observed that the MJC plantarflexion (arch raising) during the midstance and late stance leads the pelvis backward, avoiding excessive forward displacement. The MJC was the second joint that contributed most to the pelvis positions (around 18% of all joints' contributions), after the ankle joint. The MJC and ankle were the joints that were most frequently coordinated with the other joints (≅70% of the stance phase duration). The findings suggest that the MJC is part of the kinematic chain that determines pelvis positions during walking and is functionally coordinated with the lower limb joints.
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Affiliation(s)
- Leonardo D Barsante
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paula M M Arantes
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Daniela V Vaz
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Fabricio A Magalhães
- College of Education, Health, and Human Sciences, Department of Biomechanics, University of Nebraska, Omaha, USA
| | - Diego S Carvalho
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Aline C Cruz
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Renan A Resende
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Juliana M Ocarino
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Sérgio T Fonseca
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Thales R Souza
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Mousavi SH, Khorramroo F, Jafarnezhadgero A. Gait retraining targeting foot pronation: A systematic review and meta-analysis. PLoS One 2024; 19:e0298646. [PMID: 38427634 PMCID: PMC10906845 DOI: 10.1371/journal.pone.0298646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/27/2024] [Indexed: 03/03/2024] Open
Abstract
Foot pronation is a prevalent condition known to contribute to a range of lower extremity injuries. Numerous interventions have been employed to address this issue, many of which are expensive and necessitate specific facilities. Gait retraining has been suggested as a promising intervention for modifying foot pronation, offering the advantage of being accessible and independent of additional materials or specific time. We aimed to systematically review the literature on the effect of gait retraining on foot pronation. We searched four databases including PubMed, Web of Science, Scopus and Embase from their inception through 20 June 2023. The Downs and Black appraisal scale was applied to assess quality of included studies. Two reviewers screened studies to identify studies reporting the effect of different methods of gait-retraining on foot pronation. Outcomes of interest were rearfoot eversion, foot pronation, and foot arch. Two authors separately extracted data from included studies. Data of interest were study design, intervention, variable, sample size and sex, tools, age, height, weight, body mass index, running experience, and weekly distance of running. Mean differences and 95% confidence intervals (CI) were calculated with random effects model in RevMan version 5.4. Fifteen studies with a total of 295 participants were included. The results of the meta-analysis showed that changing step width does not have a significant effect on peak rearfoot eversion. The results of the meta-analysis showed that changing step width does not have a significant effect on peak rearfoot eversion. Results of single studies indicated that reducing foot progression angle (MD 2.1, 95% CI 0.62, 3.58), lateralizing COP (MD -3.3, 95% CI -4.88, -1.72) can effectively reduce foot pronation. Overall, this study suggests that gait retraining may be a promising intervention for reducing foot pronation; Most of the included studies demonstrated significant improvements in foot pronation following gait retraining. Changing center of pressure, foot progression angle and forefoot strike training appeared to yield more favorable outcomes. However, further research is needed to fully understand its effectiveness and long-term benefits.
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Affiliation(s)
- Seyed Hamed Mousavi
- Faculty of Sport Sciences and Health, Department of Sport Injuries and Biomechanics, University of Tehran, Tehran, Iran
| | - Fateme Khorramroo
- Faculty of Sport Sciences and Health, Department of Sport Injuries and Biomechanics, University of Tehran, Tehran, Iran
| | - Amirali Jafarnezhadgero
- Faculty of Educational Science and Psychology, Department of Sport Managements and Biomechanics, University of Mohaghegh Ardabili, Ardabil, Iran
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Fujishita H, Ikuta Y, Maeda N, Komiya M, Morikawa M, Arima S, Sakamitsu T, Obayashi H, Fukuhara K, Ushio K, Adachi N. Effects of Rearfoot Eversion on Foot Plantar Pressure and Spatiotemporal Gait Parameters in Adolescent Athletes. Healthcare (Basel) 2023; 11:1842. [PMID: 37444676 DOI: 10.3390/healthcare11131842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/25/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Foot malalignment can augment the risk of lower-extremity injuries and lead to musculoskeletal disorders. This study aimed to clarify the contribution of rearfoot alignment to plantar pressure distribution and spatiotemporal parameters during gait in healthy adolescent athletes. METHODS This retrospective study included 39 adolescent athletes who were divided into the rearfoot eversion and control groups according to a leg heel angle of 7°. A total of 78 legs were analyzed (45 and 33 legs in the rearfoot eversion [women, 53.3%] and control groups [women, 48.5%], respectively). Gait was assessed using an in-shoe plantar pressure measuring system and a wearable inertial sensor. RESULTS The foot plantar pressure distribution in the hallux was higher in the rearfoot eversion group than that in the control group (p = 0.034). Spatiotemporal parameters showed that the foot pitch angle at heel strike was significantly larger in the rearfoot eversion group than that in the control group (24.5° vs. 21.7°; p = 0.015). Total sagittal range of motion of the ankle during the stance phase of gait was significantly larger in the rearfoot eversion group than that in the control group (102.5 ± 7.1° vs. 95.6 ± 15.8°; p = 0.020). Logistic regression analysis revealed that plantar pressure at the hallux and medial heel and foot pitch angle at heel strike were significantly associated with rearfoot eversion. CONCLUSIONS Our findings suggest that rearfoot eversion affects the gait patterns of adolescent athletes. Notably, leg heel angle assessment, which is a simple and quick procedure, should be considered as an alternative screening tool for estimating plantar pressure and spatiotemporal gait parameters to prevent sports-related and overuse injuries in adolescent athletes.
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Affiliation(s)
- Hironori Fujishita
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Yasunari Ikuta
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
| | - Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Makoto Komiya
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Masanori Morikawa
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Satoshi Arima
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Tetsuhiko Sakamitsu
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Hiromune Obayashi
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Kouki Fukuhara
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Kai Ushio
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
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Casado-Hernández I, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias M, Gómez-Salgado J, López-López D, Bayod J. Variability of the lower limb symmetry index associated with the gait parameters in the overweight adult population with flatfoot: a case-control study. Front Bioeng Biotechnol 2023; 11:1189309. [PMID: 37388764 PMCID: PMC10303102 DOI: 10.3389/fbioe.2023.1189309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/05/2023] [Indexed: 07/01/2023] Open
Abstract
Background: Adult acquired flatfoot is characterized by a medial arch collapse during monopodal support in the stance phase, developing eversion of the calcaneus and abduction of the forefoot linked to the hindfoot. The purpose of our research was to analyze the dynamic symmetry index in the lower limbs comparing patients with flatfoot and normal foot. Methods: A case-control study was carried out with a sample of 62 participants divided into two groups consisting of 31 participants were overweight with bilateral flatfoot and 31 participants with healthy feet. A portable plantar pressure platform with piezoresistive sensors was used to measure the load symmetry index in the lower limbs in the foot areas and gait phases. Results: Gait pattern analysis showed statistically significant differences in the symmetry index for lateral load (p = 0.004), the initial contact phase (p = 0.025) and the forefoot phase (p < 0.001). Conclusion: The adults were overweight with bilateral flatfoot evidenced alterations in the symmetry index in the lateral load and in the initial contact and flatfoot contact phases, showing greater instability in overweight adult flatfoot compared to the people with normal feet.
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Affiliation(s)
- Israel Casado-Hernández
- Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Madrid, Spain
| | | | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, Ferrol, Spain
| | - Javier Bayod
- Applied Mechanics and Bioengineering Group (AMB), Aragon Institute of Engineering Research (I3A), Universidad de Zaragoza, Zaragoza, Aragon, Spain
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Aquino MRC, Resende RA, Kirkwood RN, Souza TR, Fonseca ST, Ocarino JM. Spatial-temporal parameters, pelvic and lower limb movements during gait in individuals with reduced passive ankle dorsiflexion. Gait Posture 2022; 93:32-38. [PMID: 35063755 DOI: 10.1016/j.gaitpost.2022.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 12/17/2021] [Accepted: 01/12/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Proper ankle dorsiflexion range of motion (ADF-ROM) allows the anterior roll of the tibia relative to the foot during the midstance phase of gait, which contributes to forward movement of the body. Individuals with reduced passive ADF-ROM may present altered movement patterns during gait due to an inefficient anterior tibial roll over the support foot during the stance phase. RESEARCH QUESTION What is the influence of reduced passive ADF-ROM on the pelvic and lower limb movements and spatiotemporal parameters during gait? METHOD Thirty-two participants divided into two groups according to the degree of passive ADF-ROM-less than 10° (lower ADF-ROM group) or greater than 15° (higher ADF-ROM group) -were subjected to gait assessment using a three-dimensional motion analysis system. Independent t-tests were used to compare the pelvic and lower limb movements and spatiotemporal gait parameters between the groups on this cross-sectional study. RESULTS The lower ADF-ROM group had shorter step length, lower peak of pelvic ipsilateral rotation angle, and lower hip and knee maximum flexion angles in the stance phase (p < 0.05). In addition, the peaks of the ankle and forefoot-rearfoot dorsiflexion angles were smaller in the reduced ADF-ROM group (p < 0.05). The between-group differences presented effect sizes varying from moderate to large. SIGNIFICANCE Individuals with reduced passive ADF-ROM presented reduced foot and ankle dorsiflexion, knee and hip flexion, and pelvis rotation movements and shorter step length during gait. However, no differences in foot pronation were noted between groups. Therefore, individuals with reduced passive ADF-ROM present alterations in the lower limb and pelvic movements during gait.
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Affiliation(s)
- Mariana R C Aquino
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Avenida Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil.
| | - Renan A Resende
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Avenida Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil.
| | - Renata N Kirkwood
- McMaster University, Hamilton School of Rehabilitation Science, 1280 Main Street West, L8S 4L8 ON, Canada.
| | - Thales R Souza
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Avenida Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil; McMaster University, Hamilton School of Rehabilitation Science, 1280 Main Street West, L8S 4L8 ON, Canada.
| | - Sergio T Fonseca
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Avenida Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil; McMaster University, Hamilton School of Rehabilitation Science, 1280 Main Street West, L8S 4L8 ON, Canada.
| | - Juliana M Ocarino
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Avenida Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil.
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Taylor JB, Wright ES, Waxman JP, Schmitz RJ, Groves JD, Shultz SJ. Ankle Dorsiflexion Affects Hip and Knee Biomechanics During Landing. Sports Health 2021; 14:328-335. [PMID: 34096370 DOI: 10.1177/19417381211019683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Restricted ankle dorsiflexion range of motion (DFROM) has been linked to lower extremity biomechanics that place an athlete at higher risk for injury. Whether reduced DFROM during dynamic movements is due to restrictions in joint motion or underutilization of available ankle DFROM motion is unclear. HYPOTHESIS We hypothesized that both lesser total ankle DFROM and underutilization of available motion would lead to high-risk biomechanics (ie, greater knee abduction, reduced knee flexion). STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS Nineteen active female athletes (age, 20.0 ± 1.3 years; height, 1.61 ± 0.06 m; mass, 67.0 ± 10.7 kg) participated. Maximal ankle DFROM (clinical measure of ankle DFROM [DF-CLIN]) was measured in a weightbearing position with the knee flexed. Lower extremity biomechanics were measured during a drop vertical jump with 3-dimensional motion and force plate analysis. The percent of available DFROM used during landing (DF-%USED) was calculated as the peak DFROM observed during landing divided by DF-CLIN. Univariate linear regressions were performed to identify whether DF-CLIN or DF-%USED predicted knee and hip biomechanics commonly associated with injury risk. RESULTS For every 1.0° less of DF-CLIN, there was a 1.0° decrease in hip flexion excursion (r2 = 0.21, P = 0.05), 1.2° decrease in peak knee flexion angles (r2 = 0.37, P = 0.01), 0.9° decrease in knee flexion excursion (r2 = 0.40, P = 0.004), 0.002 N·m·N-1·cm-1 decrease in hip extensor work (r2 = 0.28, P = 0.02), and 0.001 N·m·N-1·cm-1 decrease in knee extensor work (r2 = 0.21, P = 0.05). For every 10% less of DF-%USED, there was a 3.2° increase in peak knee abduction angles (r2 = 0.26, P = 0.03) and 0.01 N·m·N-1·cm-1 lesser knee extensor work (r2 = 0.25, P = 0.03). CONCLUSION Lower levels of both ankle DFROM and DF-%USED are associated with biomechanics that are considered to be associated with a higher risk of sustaining injury. CLINICAL RELEVANCE While total ankle DFROM can predict some aberrant movement patterns, underutilization of available ankle DFROM can also lead to higher risk movement strategies. In addition to joint specific mobility training, clinicians should incorporate biomechanical interventions and technique feedback to promote the utilization of available motion.
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Affiliation(s)
- Jeffrey B Taylor
- Department of Physical Therapy, High Point University, High Point, North Carolina
| | - Elena S Wright
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina.,Department of Implementation Science, Division of Public Health Science, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Center for Healthcare Innovation, Wake Forest Baptist Health, Winston Salem, North Carolina
| | - Justin P Waxman
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Randy J Schmitz
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - James D Groves
- Department of Physical Therapy, The University of Tennessee Health Science Center, Memphis, Tennessee
| | - Sandra J Shultz
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina
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Fajardo CDC, Cardoso TB, Gontijo BA, Magalhães FAD, Souza TRD, Fonseca STD, Ocarino JDM, Resende RA. Hip passive stiffness is associated with midfoot passive stiffness. Braz J Phys Ther 2021; 25:530-535. [PMID: 33658164 DOI: 10.1016/j.bjpt.2021.02.001] [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] [Received: 05/01/2020] [Revised: 01/19/2021] [Accepted: 02/01/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Hip motion in the transverse plane is coupled with foot motion in the frontal plane during closed kinematic activities, such as gait. Considering that movement patterns and bone alignment might influence passive mechanical properties of joints in the long term, it is possible that hip passive stiffness and foot complex stiffness and alignment are related to each other. OBJECTIVES To investigate whether hip passive stiffness, midfoot passive stiffness and shank-forefoot alignment are related to each other. METHOD Thirty healthy adult individuals with a mean age of 25.4 years participated (18 women and 12 men). The Foot Torsimeter was used to measure midfoot stiffness, and hip stiffness and foot alignment were measured using clinical measures. Pearson and Spearman correlation coefficients were calculated to test the associations between each pair of variables, with α = 0.05. RESULTS Hip stiffness was positively correlated with midfoot absolute stiffness (r = 0.41, p = 0.02), indicating that increased hip stiffness is associated with increased midfoot stiffness. There were no associations between shank-forefoot alignment and the other variables. CONCLUSIONS In clinical settings, individuals with reduced hip passive stiffness may also have reduced midfoot passive stiffness, and vice versa. Shank-forefoot alignment is not linearly associated with hip or midfoot passive stiffness.
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Affiliation(s)
- Clara de Castro Fajardo
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Thais Brasil Cardoso
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Bruna Antônia Gontijo
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Fabrício Anício de Magalhães
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Thales Rezende de Souza
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Sérgio Teixeira da Fonseca
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Juliana de Melo Ocarino
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Renan Alves Resende
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Morante Naranjo J, Sanchis Sales E. Relación entre la dorsiflexión de tobillo y la dorsiflexión de la primera articulación metatarsofalángica en las fases de apoyo total y despegue de la marcha: estudio transversal en sujetos sanos. REVISTA ESPAÑOLA DE PODOLOGÍA 2021. [DOI: 10.20986/revesppod.2021.1602/2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Sung PS, Schalk B, Camp R, Park MS. Gender difference of hip-ankle compensations following a novel trip perturbation in young adults. Clin Biomech (Bristol, Avon) 2020; 80:105194. [PMID: 33086186 DOI: 10.1016/j.clinbiomech.2020.105194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/18/2020] [Accepted: 10/06/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Women have an increased likelihood of sustaining a fall-related injury compared to men; however, little is known about fall prevention strategies between genders. The purpose of this study was to compare the gender differences in lower limb reactions and three-dimensional recovery patterns following a treadmill-induced trip perturbation. METHODS Seventy-six participants who are right limb dominant enrolled in the study, which included 41 females (26.15 [9.92] years old) and 35 males (27.11 [9.15] years old). The outcome measures included a three-dimensional (3D) range of motion (ROM) analysis on the bilateral hip, knee, and ankle joints following the trip perturbation at a 0.89 m/s velocity for 0.12 m. This induced trip caused subjects to walk forward for a 0.26 s duration. FINDINGS The female group demonstrated significantly increased frontal plane ROM in the right hip (t = 2.71, p = 0.01) and left ankle (t = 2.16, p = 0.03) as well as increased sagittal plane ROM in the right (t = 2.07, p = 0.04) and left (t = 2.36, p = 0.02) ankles. There was a significant gender interaction on 3D body region (F = 6.84, p = 0.01) following the perturbation. INTERPRETATION There was a 3D gender difference on the lower limbs for balance control. The female group demonstrated increased sagittal motion in both ankles following a trip perturbation. In addition, their ROM increased on the dominant hip and non-dominant ankle in the frontal plane, which was compensated by step width for standing stability. Clinicians might want to consider the implications of gender differences on lower limb reaction patterns to help patients avoid potential injuries/falls.
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Affiliation(s)
- Paul S Sung
- Department of Physical Therapy/Motion Analysis Center, Central Michigan University, Mount Pleasant, MI 48858, USA.
| | - Bradly Schalk
- Department of Physical Therapy/Motion Analysis Center, Central Michigan University, Mount Pleasant, MI 48858, USA
| | - Ryan Camp
- Department of Physical Therapy/Motion Analysis Center, Central Michigan University, Mount Pleasant, MI 48858, USA
| | - Moon Soo Park
- Department of Physical Therapy/Motion Analysis Center, Central Michigan University, Mount Pleasant, MI 48858, USA
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The Acute Influence of Running-Induced Fatigue on the Performance and Biomechanics of a Countermovement Jump. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10124319] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Lower limb kinematics and kinetics during the landing phase of jumping might change because of localized muscle fatigue. This study aimed to investigate the acute influence of running-induced fatigue on the performance and lower limb kinematics and kinetics of a countermovement jump. A running-induced fatigue protocol was applied to fifteen male subjects. Participants were asked to perform three successful countermovement jumps before and after fatigue. Kinematic and kinetic data were collected to compare any fatigue influences. Wilcoxon signed-rank tests and paired-sample t-tests were used to analyze the data. Running-induced fatigue did not significantly change vertical jump height and peak vertical ground reaction forces (GRF) during the push-off and landing phases. Lower limb biomechanics significantly changed, especially kinematic parameters. During the push-off phase, fatigue resulted in an increased ankle peak inversion angle, knee minimal flexion angle, knee peak abduction angle, and hip peak flexion moment. In addition, the range of motion (ROM) of the ankle and knee joints in the frontal plane was also increased. Certain parameters decreased as a result of fatigue, such as the ankle peak internal rotation angle, hip peak abduction angle, the ROM of the ankle joint in the sagittal plane, and ROM of the hip joint in the frontal plane. During the landing phase, the peak inversion angle and peak external rotation angle of the ankle joint, peak abduction angle of the knee and hip joint, ROM of the ankle joint in the horizontal plane, ROM of the ankle and knee joint in the frontal plane were all increased as a result of fatigue. The knee peak flexion moment and hip peak extension moment, however, were decreased. Under fatigue conditions, lower limb kinetics and kinematics were changed during both the push-off and landing phases. More attention should be focused on the landing phase and the last period of the push-off phase due to potentially higher risks of injury. The findings of the current study may be beneficial to athletes and coaches in preventing jumping related injuries.
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Tsujimoto N, Nunome H, Ikegami Y. Major factors influencing rearfoot external eversion moment during barefoot walking. Gait Posture 2020; 79:189-194. [PMID: 32422559 DOI: 10.1016/j.gaitpost.2020.04.029] [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] [Received: 05/22/2019] [Revised: 04/20/2020] [Accepted: 04/28/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Excessive rearfoot eversion motion during walking has been considered as a risk factor for lower limb chronic injuries. External moment due to ground reaction force (GRF) is the essential cause by which the rearfoot is passively everted during walking. RESEARCH QUESTION This study aims to identify the key factors influencing the rearfoot external eversion moments due to the GRF during walking. METHODS From 3-D foot coordinates and GRF data of 29 healthy participants during walking, the rearfoot external eversion moments due to the GRF and factors composing the moment (height of the ankle joint center, mediolateral GRF, mediolateral distance of the center of pressure relative to the ankle joint center in the transverse plane, vertical GRF) were computed. RESULTS The mediolateral GRF was a key factor influencing the magnitude of the rearfoot external eversion moment just after foot contact, with which pre-contact medial foot velocity was significantly correlated. During the subsequent support phase, the mediolateral distance of the center of pressure (the application point of the vertical GRF) relative to the ankle joint center was also found to be another determinant of the magnitude of the rearfoot external eversion moment. SIGNIFICANCE We succeeded in demonstrating the specific factors that most likely explain the magnitude of the rearfoot external eversion moment during initial contact and the subsequent support phase during walking. Based on the findings, specific measures to suppress the rearfoot external eversion moment could be proposed.
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Affiliation(s)
- Norio Tsujimoto
- Faculty of Sports and Health Sciences, Fukui University of Technology, 3-6-1, Gakuen, Fukui 910-8505, Japan.
| | - Hiroyuki Nunome
- Faculty of Sports and Health Science, Fukuoka University, 8-19-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
| | - Yasuo Ikegami
- Faculty of Health and Medical Sciences, Aichi Shukutoku University, 2-9, Katahira, Nagakute, 480-1197, Japan.
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Cardoso TB, Ocarino JM, Fajardo CC, Paes BDC, Souza TR, Fonseca ST, Resende RA. Hip external rotation stiffness and midfoot passive mechanical resistance are associated with lower limb movement in the frontal and transverse planes during gait. Gait Posture 2020; 76:305-310. [PMID: 31887703 DOI: 10.1016/j.gaitpost.2019.12.030] [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: 06/02/2019] [Revised: 12/08/2019] [Accepted: 12/20/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Hip external rotation stiffness, midfoot passive mechanical resistance and foot alignment may influence on ankle, knee and hip movement in the frontal and transverse planes during gait. RESEARCH QUESTION Are hip stiffness, midfoot mechanical resistance and foot alignment associated with ankle, knee and hip kinematics during gait? METHODS Hip stiffness, midfoot mechanical resistance, and foot alignment of thirty healthy participants (18 females and 12 males) with average age of 25.4 years were measured. In addition, lower limb kinematic data during the stance phase of gait were collected with the Qualisys System (Oqus 7+). Stepwise multiple linear regressions were performed to identify if hip stiffness, midfoot torque, midfoot stiffness and foot alignment were associated with hip and knee movement in the transverse plane and ankle movement in the frontal plane with α = 0.05. RESULTS Reduced midfoot torque was associated with higher hip range of motion (ROM) in the transverse plane (r2 = 0.18), reduced hip stiffness was associated with higher peak hip internal rotation (r2 = 0.16) and higher ROM in the frontal plane (r2 = 0.14), reduced midfoot stiffness was associated with higher peak knee internal rotation (r2 = 0.14) and increased midfoot torque and midfoot stiffness were associated with higher peak knee external rotation (r2 = 0.36). SIGNIFICANCE These findings demonstrated that individuals with reduced hip and midfoot stiffness have higher hip and knee internal rotation and higher ankle eversion during the stance phase of gait. On the other hand, individuals with increased midfoot torque and stiffness have higher knee external rotation. These relationships can be explained by the coupling between ankle movements in the frontal plane and knee and hip movements in the transverse plane. Finally, this study suggests that midfoot passive mechanical resistance and hip stiffness should be assessed in individuals presenting altered ankle, knee and hip movement during gait.
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Affiliation(s)
- Thais B Cardoso
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Avenida Antônio Carlos 6627 Campus Pampulha, Pampulha, 31270-901, Belo Horizonte, MG, Brazil.
| | - Juliana M Ocarino
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Avenida Antônio Carlos 6627 Campus Pampulha, Pampulha, 31270-901, Belo Horizonte, MG, Brazil.
| | - Clara C Fajardo
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Avenida Antônio Carlos 6627 Campus Pampulha, Pampulha, 31270-901, Belo Horizonte, MG, Brazil.
| | - Bruno D C Paes
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Avenida Antônio Carlos 6627 Campus Pampulha, Pampulha, 31270-901, Belo Horizonte, MG, Brazil.
| | - Thales R Souza
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Avenida Antônio Carlos 6627 Campus Pampulha, Pampulha, 31270-901, Belo Horizonte, MG, Brazil.
| | - Sérgio T Fonseca
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Avenida Antônio Carlos 6627 Campus Pampulha, Pampulha, 31270-901, Belo Horizonte, MG, Brazil.
| | - Renan A Resende
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Avenida Antônio Carlos 6627 Campus Pampulha, Pampulha, 31270-901, Belo Horizonte, MG, Brazil.
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13
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Bresnahan PJ, Juanto MA. Pediatric Flatfeet-A Disease Entity That Demands Greater Attention and Treatment. Front Pediatr 2020; 8:19. [PMID: 32117826 PMCID: PMC7026255 DOI: 10.3389/fped.2020.00019] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/14/2020] [Indexed: 01/23/2023] Open
Abstract
Background: Pediatric flatfoot is a common deformity. Unfortunately, the common opinion has been that most children with this faulty foot structure will simply out-grow it, despite no radiographic evidence to support this claim. Every step on a deformed foot leads to excessive tissue strain and further joint damage. Many forms of conservative and surgical treatments have been offered. This study was aimed at investigating the effectiveness of non-surgical and surgical treatment options. Main Text: faulty-foot structure is the leading cause of many secondary orthopedic deformities. A wide range of treatments for pediatric flatfeet have been recommended from the "do-nothing" approach, observation, to irreversible reconstructive surgery. Most forms of conservative care lack evidence of osseous realignment and stability. A conservative surgical option of extra-osseous talotarsal joint stabilization provides patients an effective form of treatment without the complications associated with other irreversible surgical procedures. Conclusion: Pediatric flatfeet should not be ignored or downplayed. The sooner effective treatment is prescribed, the less damage will occur to other parts of the body. When possible, a more conservative corrective procedure should be performed prior to irreversible, joint destructive options.
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Gomes RBO, Souza TR, Paes BDC, Magalhães FA, Gontijo BA, Fonseca ST, Ocarino JM, Resende RA. Foot pronation during walking is associated to the mechanical resistance of the midfoot joint complex. Gait Posture 2019; 70:20-23. [PMID: 30780086 DOI: 10.1016/j.gaitpost.2019.01.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 01/11/2019] [Accepted: 01/18/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND The demonstration of the relationship between midfoot passive mechanical resistance and foot pronation during gait may guide the development of assessment and intervention methods to modify foot motion during gait and to alter midfoot passive mechanical resistance. RESEARCH QUESTION Is foot pronation during the stance phase of gait related to the midfoot passive mechanical resistance to inversion? METHODS The resistance torque and stiffness provided by midfoot soft tissues of 33 participants (21 females and 12 males) with average of 26.21 years were measured. In addition, the participants' forefoot and rearfoot kinematic data during the stance phase of gait were collected with the Qualisys System (Oqus 7+). Correlation Coefficients were calculated to test the association between kinematic variables representing pronation (forefoot-rearfoot inversion, forefoot-rearfoot dorsiflexion and rearfoot-shank eversion) and maximum resistance torque and maximum stiffness of the midfoot with α = 0.05. RESULTS Reduced maximum midfoot resistance torque was moderately associated with increased forefoot-rearfoot inversion peak (p = 0.029; r = 0.38), with forefoot-rearfoot dorsiflexion peak (p = 0.048; r = -0.35) and with rearfoot-shank eversion peak (p = 0.008; r = -0.45). Maximum midfoot stiffness was not associated to foot pronation. SIGNIFICANCE The smaller the midfoot resistance torque, the greater the forefoot-rearfoot inversion and dorsiflexion peaks and the rearfoot-shank eversion peak during gait. The findings suggest the existence of a relationship between foot pronation and midfoot passive mechanical resistance. Thus, changes in midfoot passive mechanical resistance may affect foot pronation during gait.
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Affiliation(s)
- Raphael B O Gomes
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Belo Horizonte, MG, Brazil.
| | - Thales R Souza
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Belo Horizonte, MG, Brazil.
| | - Bruno D C Paes
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Belo Horizonte, MG, Brazil.
| | - Fabrício A Magalhães
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Belo Horizonte, MG, Brazil.
| | - Bruna A Gontijo
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Belo Horizonte, MG, Brazil.
| | - Sérgio T Fonseca
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Belo Horizonte, MG, Brazil.
| | - Juliana M Ocarino
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Belo Horizonte, MG, Brazil.
| | - Renan A Resende
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Belo Horizonte, MG, Brazil.
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15
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Simonsen MB, Yurtsever A, Næsborg-Andersen K, Leutscher PDC, Hørslev-Petersen K, Andersen MS, Hirata RP. Tibialis posterior muscle pain effects on hip, knee and ankle gait mechanics. Hum Mov Sci 2019; 66:98-108. [PMID: 30981150 DOI: 10.1016/j.humov.2019.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/14/2019] [Accepted: 04/05/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Tibialis posterior (TP) dysfunction is a common painful complication in patients with rheumatoid arthritis (RA), which can lead to the collapse of the medial longitudinal arch. Different theories have been developed to explain the causality of tibialis posterior dysfunction. In all these theories, pain is a central factor, and yet, it is uncertain to what extent pain causes the observed biomechanical alterations in the patients. The aim of this study was to investigate the effect of experimental tibialis posterior muscle pain on gait mechanics in healthy subjects. METHODS Twelve healthy subjects were recruited for this randomized crossover study. Experimental pain was induced by ultrasound-guided injection of 1 mL hypertonic saline into the upper part of the right tibialis posterior muscle with the use of isotonic saline as non-pain-inducing control. Subsequently, kinematic data during three self-paced over ground walking for each condition were collected. Ground reaction forces and external moments were measured from force plates installed in the floor. Painful areas were evaluated using body charts and pain intensity scoring via a verbal numerical rating scale. FINDINGS Decreased hip internal rotation was observed during the pain condition at the end of the stance phase. There were no changes in gait velocity and duration of stand phase between the pain and no pain conditions. Reduced external joint moment was found for external knee rotation and for external hip rotation. INTERPRETATION The study has demonstrated that induced pain in the TP muscle evokes kinematic alteration in the hip and the knee joints, but not in the ankle, which suggest an underlying early stage joint compensatory mechanism. These findings suggest the need to include those joints in current physical evaluations of tibialis posterior dysfunction.
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Affiliation(s)
- Morten Bilde Simonsen
- Center for Sensory-Motoric Interaction (SMI®), Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7, DK-9220 Aalborg East, Denmark; Centre for Clinical Research, North Denmark Regional Hospital, Bispensgade 37, DK-9800 Hjoerring, Denmark
| | - Aysun Yurtsever
- Centre for Clinical Research, North Denmark Regional Hospital, Bispensgade 37, DK-9800 Hjoerring, Denmark; Department of Rheumatology, Hjørring Hospital, Bispensgade 37, DK-9800 Hjørrring, Denmark
| | - Ketill Næsborg-Andersen
- Centre for Clinical Research, North Denmark Regional Hospital, Bispensgade 37, DK-9800 Hjoerring, Denmark
| | - Peter Derek Christian Leutscher
- Centre for Clinical Research, North Denmark Regional Hospital, Bispensgade 37, DK-9800 Hjoerring, Denmark; Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, DK-9000, Denmark
| | - Kim Hørslev-Petersen
- King Christian 10th Hospital for Rheumatic Diseases, University of Southern Denmark, Toldbodgade 3, DK-6300 Gråsten, Denmark
| | - Michael Skipper Andersen
- Department of Materials and Production, Aalborg University, Fibigerstraede 16, DK-9220 Aalborg East, Denmark
| | - Rogerio Pessoto Hirata
- Center for Sensory-Motoric Interaction (SMI®), Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7, DK-9220 Aalborg East, Denmark.
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