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Gao T, Ma Z, Yang N, Zhang S, Shi H, Zhang H, Ren S, Huang H. The relationship of peak ankle dorsiflexion angle with lower extremity biomechanics during walking. J Foot Ankle Res 2024; 17:e12027. [PMID: 38812103 DOI: 10.1002/jfa2.12027] [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: 03/08/2024] [Accepted: 05/08/2024] [Indexed: 05/31/2024] Open
Abstract
PURPOSE Abnormal lower limb movement patterns have been observed during walking in individuals with limited ankle dorsiflexion. The purpose of this study was to investigate the relationships of peak ankle dorsiflexion angle during the stance phase of walking with the lower extremity biomechanics at the corresponding moment and to determine a cutoff value of functional limited ankle dorsiflexion during walking. METHODS Kinematic and kinetic data of 70 healthy participants were measured during walking. Spearman's correlation coefficients were calculated to establish the association between peak ankle dorsiflexion and angle and moment of ankle, knee, and hip, ground reaction force, and pelvic movement at peak ankle dorsiflexion. All variables significantly related to peak ankle dorsiflexion were extracted as a common factor by factor analysis. Maximally selected Wilcoxon statistic was used to perform a cutoff value analysis. RESULTS Peak ankle dorsiflexion positively correlated with ankle plantar flexion moment (r = 0.432; p = 0.001), ankle external rotation moment (r = 0.251; p = 0.036), hip extension angle (r = 0.281; p = 0.018), hip flexion moment (r = 0.341; p = 0.004), pelvic ipsilateral rotation angle (r = 0.284; p = 0.017), and medial, anterior, and vertical ground reaction force (r = 0.324; p = 0.006, r = 0.543; p = 0.001, r = 0.322; p = 0.007), negatively correlated with knee external rotation angle (r = -0.394; p = 0.001) and hip adduction angle (r = -0.256; p = 0.032). The cutoff baseline value for all 70 participants was 9.03°. CONCLUSIONS There is a correlation between the peak ankle dorsiflexion angle and the lower extremity biomechanics during walking. If the peak ankle dorsiflexion angle is less than 9.03°, the lower limb movement pattern will change significantly.
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Affiliation(s)
- Tianyu Gao
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Institute of Sport, Exercise & Health, Tianjin University of Sport, Tianjin, China
| | - Zhengye Ma
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
| | - Nan Yang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Institute of Sport, Exercise & Health, Tianjin University of Sport, Tianjin, China
| | - Si Zhang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
| | - Haitao Shi
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Institute of Sport, Exercise & Health, Tianjin University of Sport, Tianjin, China
| | - Hua Zhang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Shuang Ren
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
| | - Hongshi Huang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Institute of Sport, Exercise & Health, Tianjin University of Sport, Tianjin, China
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Christopher SM, Donnelly G, Brockwell E, Bo K, Davenport MH, De Vivo M, Dufour S, Forner L, Mills H, Moore IS, Olson A, Deering RE. Clinical and exercise professional opinion of return-to-running readiness after childbirth: an international Delphi study and consensus statement. Br J Sports Med 2024; 58:299-312. [PMID: 38148108 DOI: 10.1136/bjsports-2023-107489] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 12/28/2023]
Abstract
Female athletes have identified a lack of guidance as a barrier to successfully returning to running postpartum, and existing guidelines are vague. Our aim was to define the current practice of determining postpartum run-readiness through a consensus survey of international clinicians and exercise professionals in postpartum exercise to assist clinicians and inform sport policy changes.A three-round Delphi approach was used to gain international consensus from clinicians and exercise professionals on run-readiness postpartum. Professionals who work with postpartum runners participated in an online survey to answer open-ended questions about the following postpartum return-to-running topics: definitions (runner and postpartum), key biopsychosocial milestones that runners need to meet, recommended screening, timeline to initiate running, support items, education topics and factors that contribute to advising against running. Consensus was defined as ≥75% participant agreement.One hundred and eighteen professionals participated in round I, 107 participated in round II (response rate 90.6%) and 95 participated in round III (response rate 80.5%). Responses indicated that, following a minimum 3-week period of rest and recovery, an individualised timeline and gradual return to running progression can be considered. Screening for medical and psychological concerns, current physical capacity, and prior training history is recommended prior to a return to running.This study proposes recommendations for the initial guidance on return-to-running postpartum, framed in the context of current research and consensus from professionals. Future research is needed to strengthen and validate specific recommendations and develop guidelines for best practice when returning-to-running after childbirth.
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Affiliation(s)
- Shefali Mathur Christopher
- Department of Rehabilitation Sciences, Doctor of Physical Therapy, Tufts University, Seattle, Washington, USA
- Elon University, Elon, North Carolina, USA
| | - Gráinne Donnelly
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | | | - Kari Bo
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lorenskog, Norway
| | - Margie H Davenport
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Marlize De Vivo
- Perinatal Physical Activity Research Group, School of Psychology and Life Sciences, Section of Sport, Exercise and Rehabilitation Science, Canterbury Christ Church University, Canterbury, UK
- Active Pregnancy Foundation, None, UK
| | - Sinead Dufour
- The World of my Baby (WOMB), Faculty of Health Science, McMaster University, Hamilton, Ontario, Canada
| | - Lori Forner
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Hayley Mills
- Perinatal Physical Activity Research Group, School of Psychology and Life Sciences, Section of Sport, Exercise and Rehabilitation Science, Canterbury Christ Church University, Canterbury, UK
| | - Isabel S Moore
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | | | - Rita E Deering
- Department of Physical Therapy, Carroll University, Waukesha, Wisconsin, USA
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, USA
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DeJong Lempke AF, Hunt DL, Dawkins C, Stracciolini A, Kocher MS, d'Hemecourt PA, Whitney KE. Adolescent and young adult hip and knee strength profiles relate to running gait biomechanics. Phys Ther Sport 2023; 64:48-54. [PMID: 37741000 DOI: 10.1016/j.ptsp.2023.09.005] [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: 07/18/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVES Compare and assess relationships between strength and running biomechanics among healthy adolescents and young adult males and females. DESIGN Retrospective cohort. SETTING Clinic. PARTICIPANTS 802 healthy participants (570 F, 232 M; 16.6 ± 2.3 years). MAIN OUTCOME MEASURES Mass-normalized knee flexor and extensor strength, hip adductor and abductor strength, hamstrings-to-quadriceps (H:Q), and abductor-to-adductor (Abd:Add) ratios were obtained using hand-held dynamometry. Mass-normalized peak vertical ground reaction force (vGRF), %stance, cadence, and stride length were obtained using an instrumented treadmill. Multivariate analyses of variance were used to compare strength and biomechanics across ages and sexes. Linear regressions were used to assess the relationships between strength and biomechanics, accounting for speed, age, and sex. Independent t-tests were used to compare strength between strength ratio profiles. RESULTS Strength and running biomechanics significantly differed between sexes (p-range: <0.001-0.05) and age groups (p-range: <0.001-0.02). Strength and strength ratios were significantly associated with increased cadence (p-range:0.001-0.04) and stride lengths (p-range:0.004-0.03), and decreased vGRF (p < 0.001). Lower H:Q ratios had significantly lower strength measures (p < 0.001). Higher Abd:Add ratios had significantly increased abductor strength (p < 0.001). CONCLUSIONS Strength and running biomechanics differed by sexes and ages. Hip and knee strength and strength ratios were related to select spatiotemporal and kinetic biomechanical features.
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Affiliation(s)
- Alexandra F DeJong Lempke
- School of Kinesiology, University of Michigan, Ann Arbor, 830 N University Ave, Ann Arbor, MI, 48109, USA.
| | - Danielle L Hunt
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA
| | - Corey Dawkins
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA
| | - Andrea Stracciolini
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA; Harvard Medical School, 319 Longwood Avenue, Boston, MA, 20115, USA
| | - Mininder S Kocher
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA; Harvard Medical School, 319 Longwood Avenue, Boston, MA, 20115, USA
| | - Pierre A d'Hemecourt
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA; Harvard Medical School, 319 Longwood Avenue, Boston, MA, 20115, USA
| | - Kristin E Whitney
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA; Harvard Medical School, 319 Longwood Avenue, Boston, MA, 20115, USA
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