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Wishaupt K, Schallig W, van Dorst MH, Buizer AI, van der Krogt MM. The applicability of markerless motion capture for clinical gait analysis in children with cerebral palsy. Sci Rep 2024; 14:11910. [PMID: 38789587 PMCID: PMC11126730 DOI: 10.1038/s41598-024-62119-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
The aim of this comparative, cross-sectional study was to determine whether markerless motion capture can track deviating gait patterns in children with cerebral palsy (CP) to a similar extent as marker-based motion capturing. Clinical gait analysis (CGA) was performed for 30 children with spastic CP and 15 typically developing (TD) children. Marker data were processed with the Human Body Model and video files with Theia3D markerless software, to calculate joint angles for both systems. Statistical parametric mapping paired t-tests were used to compare the trunk, pelvis, hip, knee and ankle joint angles, for both TD and CP, as well as for the deviation from the norm in the CP group. Individual differences were quantified using mean absolute differences. Markerless motion capture was able to track frontal plane angles and sagittal plane knee and ankle angles well, but individual deviations in pelvic tilt and transverse hip rotation as present in CP were not captured by the system. Markerless motion capture is a promising new method for CGA in children with CP, but requires improvement to better capture several clinically relevant deviations especially in pelvic tilt and transverse hip rotation.
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Affiliation(s)
- Koen Wishaupt
- Department of Rehabilitation Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Wouter Schallig
- Department of Rehabilitation Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands
| | - Marleen H van Dorst
- Department of Rehabilitation Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands
| | - Annemieke I Buizer
- Department of Rehabilitation Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands
- Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands
| | - Marjolein M van der Krogt
- Department of Rehabilitation Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands
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2
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Tashiro T, Ikuta Y, Maeda N, Arima S, Morikawa M, Kaneda K, Ishihara H, Tsutsumi S, Kawai M, Brand A, Nakasa T, Adachi N, Komiya M, Urabe Y. First tarsometatarsal joint mobility in hallux valgus during gait: A synchronized ultrasound and three-dimensional motion capture analysis. J Med Ultrason (2001) 2024; 51:331-339. [PMID: 38546904 PMCID: PMC11098882 DOI: 10.1007/s10396-024-01414-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/28/2024] [Indexed: 05/19/2024]
Abstract
PURPOSE To quantify the vertical translation between the first metatarsal and medial cuneiform during the stance phase of gait in young individuals with and without hallux valgus. DESIGN This cross-sectional observational study included 34 young adults (male, n = 4; female, n = 30) who were divided into three groups according to the hallux valgus angle: control (< 20°, n = 13), mild hallux valgus (≥ 20° to < 30°, n = 12), and moderate hallux valgus (≥ 30°, n = 9). The mobility of the first tarsometatarsal joint was evaluated during the stance phase using B-mode ultrasound synchronized with a motion analysis system. RESULTS The medial cuneiform shifted more plantar during the early phase in mild hallux valgus and during the middle and terminal phases in moderate hallux valgus than in control. The severity of the hallux valgus was correlated with a trend toward plantar shift of the medial cuneiform. The first metatarsal was located more dorsal than the medial cuneiform; however, there was no significant variation. No significant differences in the peak ankle plantarflexion angle and moment were noted between the groups. CONCLUSION The hypermobility of the first tarsometatarsal joint, especially plantar displacement of the medial cuneiform in the sagittal plane, was found in young individuals with hallux valgus during the stance phase of gait, and the mobility increased with the severity of hallux valgus. Our findings suggest the significance of preventing hallux valgus deformity early in life.
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Affiliation(s)
- Tsubasa Tashiro
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Yasunari Ikuta
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Satoshi Arima
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, 474-8511, Japan
| | - Kazuki Kaneda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Honoka Ishihara
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Shogo Tsutsumi
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Miki Kawai
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Andreas Brand
- Institute for Biomechanics, BG Unfallklinik Murnau, Murnau, Germany
- Institute for Biomechanics, Paracelsus Medical Private University Salzburg, Salzburg, Austria
| | - Tomoyuki Nakasa
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Nobuo Adachi
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Makoto Komiya
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Yukio Urabe
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan.
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3
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Hulshof CM, Schallig W, van den Noort JC, Streekstra GJ, Kleipool RP, Gg Dobbe J, Maas M, Harlaar J, van der Krogt MM. Skin marker-based versus bone morphology-based coordinate systems of the hindfoot and forefoot. J Biomech 2024; 166:112001. [PMID: 38527409 DOI: 10.1016/j.jbiomech.2024.112001] [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: 10/11/2023] [Revised: 01/31/2024] [Accepted: 02/14/2024] [Indexed: 03/27/2024]
Abstract
Segment coordinate systems (CSs) of marker-based multi-segment foot models are used to measure foot kinematics, however their relationship to the underlying bony anatomy is barely studied. The aim of this study was to compare marker-based CSs (MCSs) with bone morphology-based CSs (BCSs) for the hindfoot and forefoot. Markers were placed on the right foot of fifteen healthy adults according to the Oxford, Rizzoli and Amsterdam Foot Model (OFM, RFM and AFM, respectively). A CT scan was made while the foot was loaded in a simulated weight-bearing device. BCSs were based on axes of inertia. The orientation difference between BCSs and MCSs was quantified in helical and 3D Euler angles. To determine whether the marker models were able to capture inter-subject variability in bone poses, linear regressions were performed. Compared to the hindfoot BCS, all MCSs were more toward plantar flexion and internal rotation, and RFM was also oriented toward more inversion. Compared to the forefoot BCS, OFM and RFM were oriented more toward dorsal and plantar flexion, respectively, and internal rotation, while AFM was not statistically different in the sagittal and transverse plane. In the frontal plane, OFM was more toward eversion and RFM and AFM more toward inversion compared to BCS. Inter-subject bone pose variability was captured with RFM and AFM in most planes of the hindfoot and forefoot, while this variability was not captured by OFM. When interpreting multi-segment foot model data it is important to realize that MCSs and BCSs do not always align.
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Affiliation(s)
- Chantal M Hulshof
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118 1081 HZ, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands.
| | - Wouter Schallig
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118 1081 HZ, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands.
| | - Josien C van den Noort
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Geert J Streekstra
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands
| | - Roeland P Kleipool
- Department of Medical Biology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands
| | - Johannes Gg Dobbe
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands
| | - Mario Maas
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Jaap Harlaar
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118 1081 HZ, Amsterdam, the Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2 2628 CD, Delft, the Netherlands; Department of Orthopedics & Sports Medicine, Erasmus MC, Doctor Molewaterplein 40 3015 GD, Rotterdam, the Netherlands
| | - Marjolein M van der Krogt
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118 1081 HZ, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
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4
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Wang Y, Qi Y, Ma B, Wu H, Wang Y, Wei B, Wei X, Xu Y. Three-dimensional gait analysis of orthopaedic common foot and ankle joint diseases. Front Bioeng Biotechnol 2024; 12:1303035. [PMID: 38456008 PMCID: PMC10919227 DOI: 10.3389/fbioe.2024.1303035] [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: 09/27/2023] [Accepted: 02/02/2024] [Indexed: 03/09/2024] Open
Abstract
Walking is an indispensable mode of transportation for human survival. Gait is a characteristic of walking. In the clinic, patients with different diseases exhibit different gait characteristics. Gait analysis describes the specific situation of human gait abnormalities by observing and studying the kinematics and dynamics of limbs and joints during human walking and depicting the corresponding geometric curves and values. In foot and ankle diseases, gait analysis can evaluate the degree and nature of gait abnormalities in patients and provide an important basis for the diagnosis of patients' diseases, the correction of abnormal gait and related treatment methods. This article reviews the relevant literature, expounds on the clinical consensus on gait, and summarizes the gait characteristics of patients with common ankle and foot diseases. Starting from the gait characteristics of individuals with different diseases, we hope to provide support and reference for the diagnosis, treatment and rehabilitation of clinically related diseases.
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Affiliation(s)
| | | | | | | | | | | | | | - Yongsheng Xu
- Orthopedic Center (Sports Medicine Center), Inner Mongolia People’s Hospital, Hohhot, China
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5
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Luo Y, Li Z, Hu M, Zhang L, Li F, Wang S. Effects of fatigue on the in vivo kinematics and kinetics of talocrural and subtalar joint during landing. Front Bioeng Biotechnol 2023; 11:1252044. [PMID: 37829568 PMCID: PMC10566632 DOI: 10.3389/fbioe.2023.1252044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/28/2023] [Indexed: 10/14/2023] Open
Abstract
Objective: Fatigue can affect the ankle kinematic characteristics of landing movements. Traditional marker-based motion capture techniques have difficulty in accurately obtaining the kinematics of the talocrural and subtalar joints. This study aimed to investigate the effects of fatigue on the talocrural and subtalar joints during the landing using dual fluoroscopic imaging system (DFIS). Methods: This study included fourteen healthy participants. The foot of each participant was scanned using magnetic resonance imaging to create 3D models. High-speed DFIS was used to capture images of the ankle joint during participants performing a single-leg landing jump from a height of 40 cm. Fatigue was induced by running and fluoroscopic images were captured before and after fatigue. Kinematic data were obtained by 3D/2D registration in virtual environment software. The joint kinematics in six degrees of freedom and range of motion (ROM) were compared between the unfatigued and fatigued conditions. Results: During landing, after the initial contact with the ground, the main movement of the talocrural joint is extension and abduction, while the subtalar joint mainly performs extension, eversion, and abduction. Compared to unfatigued, during fatigue the maximum medial translation (1.35 ± 0.45 mm vs. 1.86 ± 0.69 mm, p = 0.032) and medial-lateral ROM (3.19 ± 0.60 mm vs. 3.89 ± 0.96 mm, p = 0.029) of the talocrural joint significantly increased, the maximum flexion angle (0.83 ± 1.24° vs. 2.11 ± 1.80°, p = 0.037) of the subtalar joint significantly increased, and the flexion-extension ROM (6.17 ± 2.21° vs. 7.97 ± 2.52°, p = 0.043) of the subtalar joint significantly increased. Conclusion: This study contributes to the quantitative understanding of the normal function of the talocrural and subtalar joints during high-demand activities. During landing, the main movement of the talocrural joint is extension and abduction, while the subtalar joint mainly performs extension, eversion, and abduction. Under fatigue conditions, the partial ROM of the talocrural and subtalar joints increases.
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Affiliation(s)
- Ye Luo
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Zhuman Li
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Mengling Hu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Ling Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Feng Li
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Shaobai Wang
- 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
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6
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Wellenberg RHH, Schallig W, Steenbergen P, Tex PD, Dobbe JGG, Streekstra GJ, Witbreuk MMEH, Buizer AI, Maas M. Assessment of foot deformities in individuals with cerebral palsy using weight-bearing CT. Skeletal Radiol 2022; 52:1313-1320. [PMID: 36585514 DOI: 10.1007/s00256-022-04272-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/21/2022] [Accepted: 12/21/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aims of this study were to visualize and quantify relative bone positions in the feet of individuals with cerebral palsy (CP) with a foot deformity and compare bone positions with those of typically developed (TD) controls. MATERIALS AND METHODS Weight-bearing CT images of 14 individuals with CP scheduled for tendon transfer and/or bony surgery and of 20 TD controls were acquired on a Planmed Verity WBCT scanner. Centroids of the navicular and calcaneus with respect to the talus were used to quantify foot deformities. All taluses were aligned and the size and dimensions of the individuals' talus were scaled to correct for differences in bone sizes. In order to visualize and quantify variations in relative bone positions, 95% CI ellipsoids and standard deviations in its principle X-, Y-, and Z-directions were determined. RESULTS In individuals with CP (age 11-17), a large variation in centroid positions was observed compared to data of TD controls. Radiuses of the ellipsoids, representing the standard deviations of the 95% CI in the principle X-, Y-, and Z-directions, were larger in individuals with CP compared to TD controls for both the calcaneus (3.16 vs 1.86 mm, 4.26 vs 2.60 mm, 9.19 vs 3.60 mm) and navicular (4.63 vs 1.55 mm, 5.18 vs 2.10 mm, 16.07 vs 4.16 mm). CONCLUSION By determining centroids of the calcaneus and navicular with respect to the talus on WBCT images, normal and abnormal relative bone positions can be visualized and quantified in individuals with CP with various foot deformities.
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Affiliation(s)
- R H H Wellenberg
- Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands. .,Orthopedic Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
| | - W Schallig
- Rehabilitation Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Rehabilitation Medicine, Amsterdam UMC Location Vrije Universiteit, de Boelelaan 1118, Amsterdam, The Netherlands.,Orthopedic Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - P Steenbergen
- Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - P den Tex
- Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - J G G Dobbe
- Biomedical Engineering and Physics, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - G J Streekstra
- Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Biomedical Engineering and Physics, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - M M E H Witbreuk
- Orthopedic Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - A I Buizer
- Rehabilitation Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Rehabilitation Medicine, Amsterdam UMC Location Vrije Universiteit, de Boelelaan 1118, Amsterdam, The Netherlands.,Orthopedic Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam UMC, Pediatric Rehabilitation, Emma Children's Hospital, Meibergdreef 9, Amsterdam, The Netherlands
| | - M Maas
- Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
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7
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Cao L, Kyung MG, Park GY, Hwang IU, Kang HW, Lee DY. Foot and Ankle Motion after Tibiotalocalcaneal Arthrodesis: Comparison with Tibiotalar Arthrodesis Using a Multi-Segment Foot Model. Clin Orthop Surg 2022; 14:631-644. [PMID: 36518930 PMCID: PMC9715919 DOI: 10.4055/cios22034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/30/2022] [Accepted: 05/30/2022] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Tibiotalocalcaneal arthrodesis is an established surgical procedure for treating patients with end-stage ankle joint arthritis and subtalar joint arthritis. Although it greatly relives pain, a major drawback is loss of range of motion. Although it is known to restrict an additional subtalar joint compared to tibiotalar arthrodesis, there is a lack of gait analysis studies comparing the two methods. This study aimed to evaluate the differences in kinematics of the foot and ankle joints between tibiotalar and tibiotalocalcaneal arthrodesis. We also compared preoperative and postoperative statuses for each surgical method. METHODS The study included 12 and 9 patients who underwent tibiotalar and tibiotalocalcaneal arthrodesis, respectively, and 40 healthy participants were included in the control group. The DuPont foot model was used to analyze intersegmental foot and ankle kinematics during gait. RESULTS Compared to controls, both tibiotalar and tibiotalocalcaneal arthrodesis resulted in slow gait speed with reduced stride length, increased step width, and decreased range of sagittal plane motion. Both fusion methods showed similar range of motion in all segments and planes following surgery. Coronal positions showed more supination of the forefoot and pronation of the hindfoot segment after each operation, particularly tibiotalocalcaneal arthrodesis. Gait after tibiotalocalcaneal arthrodesis did not significantly differ from that after tibiotalar arthrodesis, but there was a tendency of more pronation in the hindfoot segment. CONCLUSIONS Both fusion methods limited foot and ankle motion in similar ways. Comparing tibiotalar and tibiotalocalcaneal arthrodesis suggests that additionally fusing the subtalar joint does not cause greater movement restriction in patients. Objectively comparing tibiotalar and tibiotalocalcaneal arthrodesis will facilitate further understanding of the effect of tibiotalocalcaneal arthrodesis on movement and the value of subtalar joint motion for improved preoperative counselling.
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Affiliation(s)
- Linying Cao
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Min Gyu Kyung
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Gil Young Park
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Il-Ung Hwang
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Ho Won Kang
- Department of Orthopedic Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Dong Yeon Lee
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
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8
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Matsumoto Y, Ogihara N, Hanawa H, Kokubun T, Kanemura N. Novel Multi-Segment Foot Model Incorporating Plantar Aponeurosis for Detailed Kinematic and Kinetic Analyses of the Foot With Application to Gait Studies. Front Bioeng Biotechnol 2022; 10:894731. [PMID: 35814002 PMCID: PMC9265906 DOI: 10.3389/fbioe.2022.894731] [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: 03/12/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Kinetic multi-segment foot models have been proposed to evaluate the forces and moments generated in the foot during walking based on inverse dynamics calculations. However, these models did not consider the plantar aponeurosis (PA) despite its potential importance in generation of the ground reaction forces and storage and release of mechanical energy. This study aimed to develop a novel multi-segment foot model incorporating the PA to better elucidate foot kinetics. The foot model comprised three segments: the phalanx, forefoot, and hindfoot. The PA was modeled using five linear springs connecting the origins and the insertions via intermediate points. To demonstrate the efficacy of the foot model, an inverse dynamic analysis of human gait was performed and how the inclusion of the PA model altered the estimated joint moments was examined. Ten healthy men walked along a walkway with two force plates placed in series close together. The attempts in which the participant placed his fore- and hindfoot on the front and rear force plates, respectively, were selected for inverse dynamic analysis. The stiffness and the natural length of each PA spring remain largely uncertain. Therefore, a sensitivity analysis was conducted to evaluate how the estimated joint moments were altered by the changes in the two parameters within a range reported by previous studies. The present model incorporating the PA predicted that 13%–45% of plantarflexion in the metatarsophalangeal (MTP) joint and 8%–29% of plantarflexion in the midtarsal joints were generated by the PA at the time of push-off during walking. The midtarsal joint generated positive work, whereas the MTP joint generated negative work in the late stance phase. The positive and negative work done by the two joints decreased, indicating that the PA contributed towards transfer of the energy absorbed at the MTP joint to generate positive work at the midtarsal joint during walking. Although validation is limited due to the difficulty associated with direct measurement of the PA force in vivo, the proposed novel foot model may serve as a useful tool to clarify the function and mechanical effects of the PA and the foot during dynamic movements.
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Affiliation(s)
- Yuka Matsumoto
- Graduate School of Saitama Prefectural University, Graduate Course of Health and Social Services, Saitama, Japan
| | - Naomichi Ogihara
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
| | - Hiroki Hanawa
- Department of Health Science, University of Human Arts and Sciences, Saitama, Japan
| | - Takanori Kokubun
- Department of Health and Social Services, Saitama Prefectural University, Saitama, Japan
| | - Naohiko Kanemura
- Department of Health and Social Services, Saitama Prefectural University, Saitama, Japan
- *Correspondence: Naohiko Kanemura,
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9
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Schallig W, van den Noort JC, Piening M, Streekstra GJ, Maas M, van der Krogt MM, Harlaar J. The Amsterdam Foot Model: a clinically informed multi-segment foot model developed to minimize measurement errors in foot kinematics. J Foot Ankle Res 2022; 15:46. [PMID: 35668453 PMCID: PMC9172122 DOI: 10.1186/s13047-022-00543-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 05/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background Foot and ankle joint kinematics are measured during clinical gait analyses with marker-based multi-segment foot models. To improve on existing models, measurement errors due to soft tissue artifacts (STAs) and marker misplacements should be reduced. Therefore, the aim of this study is to define a clinically informed, universally applicable multi-segment foot model, which is developed to minimize these measurement errors. Methods The Amsterdam foot model (AFM) is a follow-up of existing multi-segment foot models. It was developed by consulting a clinical expert panel and optimizing marker locations and segment definitions to minimize measurement errors. Evaluation of the model was performed in three steps. First, kinematic errors due to STAs were evaluated and compared to two frequently used foot models, i.e. the Oxford and Rizzoli foot models (OFM, RFM). Previously collected computed tomography data was used of 15 asymptomatic feet with markers attached, to determine the joint angles with and without STAs taken into account. Second, the sensitivity to marker misplacements was determined for AFM and compared to OFM and RFM using static standing trials of 19 asymptomatic subjects in which each marker was virtually replaced in multiple directions. Third, a preliminary inter- and intra-tester repeatability analysis was performed by acquiring 3D gait analysis data of 15 healthy subjects, who were equipped by two testers for two sessions. Repeatability of all kinematic parameters was assessed through analysis of the standard deviation (σ) and standard error of measurement (SEM). Results The AFM was defined and all calculation methods were provided. Errors in joint angles due to STAs were in general similar or smaller in AFM (≤2.9°) compared to OFM (≤4.0°) and RFM (≤6.7°). AFM was also more robust to marker misplacement than OFM and RFM, as a large sensitivity of kinematic parameters to marker misplacement (i.e. > 1.0°/mm) was found only two times for AFM as opposed to six times for OFM and five times for RFM. The average intra-tester repeatability of AFM angles was σ:2.2[0.9°], SEM:3.3 ± 0.9° and the inter-tester repeatability was σ:3.1[2.1°], SEM:5.2 ± 2.3°. Conclusions Measurement errors of AFM are smaller compared to two widely-used multi-segment foot models. This qualifies AFM as a follow-up to existing foot models, which should be evaluated further in a range of clinical application areas. Supplementary Information The online version contains supplementary material available at 10.1186/s13047-022-00543-6.
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Affiliation(s)
- Wouter Schallig
- Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, De Boelelaan 1117, Amsterdam, The Netherlands. .,Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands. .,Amsterdam UMC location University of Amsterdam, Radiology and Nuclear Medicine, Meibergdreef 9, Amsterdam, the Netherlands.
| | - Josien C van den Noort
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands.,Amsterdam UMC location University of Amsterdam, Radiology and Nuclear Medicine, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, the Netherlands
| | - Marjolein Piening
- Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Geert J Streekstra
- Amsterdam UMC location University of Amsterdam, Radiology and Nuclear Medicine, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, the Netherlands.,Amsterdam UMC location University of Amsterdam, Biomedical Engineering and Physics, Meibergdreef 9, Amsterdam, the Netherlands
| | - Mario Maas
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands.,Amsterdam UMC location University of Amsterdam, Radiology and Nuclear Medicine, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, the Netherlands
| | - Marjolein M van der Krogt
- Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, De Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Jaap Harlaar
- Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, De Boelelaan 1117, Amsterdam, The Netherlands.,Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands.,Department of Orthopedics & Sports Medicine , ErasmusMC, Rotterdam, the Netherlands
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10
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Kawakami W, Iwamoto Y, Takeuchi Y, Takeuchi R, Sekiya J, Ishii Y, Takahashi M. Young females with hallux valgus show lower foot joint movement stability compared to controls: An investigation of coordination patterns and variability. Clin Biomech (Bristol, Avon) 2022; 94:105624. [PMID: 35339788 DOI: 10.1016/j.clinbiomech.2022.105624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/28/2022] [Accepted: 03/08/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND A kinematic coupling relationship exists between foot joints during gait. In individuals with hallux valgus, forefoot or hallux kinematics may be affected by adjacent or nonadjacent joint motion. Thus, this study aimed to investigate the foot joint coordination pattern and variability during gait in young females with hallux valgus. METHODS Twenty-five young females with hallux valgus and 25 healthy young females without hallux valgus were enrolled. Reflective markers were attached according to a multisegment foot model. Kinematic data were obtained using a three-dimensional motion analysis system. Joint angles between distal and proximal segments were calculated using analysis software. Foot joint coordination pattern and variability were assessed using a vector-coding technique. FINDINGS Individuals with hallux valgus had a larger rearfoot relative to shank eversion and forefoot relative to midfoot dorsiflexion during terminal stance and pre-swing compared with those without hallux valgus. There were no significant differences in coordination patterns, but the consistency of coordination between the rearfoot relative to shank motion in the frontal plane and forefoot relative to midfoot motion in the sagittal plane during terminal stance was greater in the hallux valgus group than in the control group. INTERPRETATION The soft tissue composing the first ray might suffer from more severe stress due to the large motion that occurred with low variability in individuals with hallux valgus. This finding may suggest that the altered kinematics and coordination variability in foot joints are related to hallux valgus biomechanical etiology.
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Affiliation(s)
- Wataru Kawakami
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Department of Rehabilitation, Kure Kyosai Hospital, Hiroshima, Japan
| | - Yoshitaka Iwamoto
- Department of Neuromechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Center for Advanced Practice and Research of Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Yasutaka Takeuchi
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryosuke Takeuchi
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Junpei Sekiya
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yosuke Ishii
- Department of Neuromechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Center for Advanced Practice and Research of Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Makoto Takahashi
- Department of Neuromechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Center for Advanced Practice and Research of Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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11
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Yoo HJ, Park HS, Lee DO, Kim SH, Park GY, Cho TJ, Lee DY. Comparison of the kinematics, repeatability, and reproducibility of five different multi-segment foot models. J Foot Ankle Res 2022; 15:1. [PMID: 34991669 PMCID: PMC8734222 DOI: 10.1186/s13047-021-00508-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 12/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multi-segment foot models (MFMs) for assessing three-dimensional segmental foot motions are calculated via various analytical methods. Although validation studies have already been conducted, we cannot compare their results because the experimental environments in previous studies were different from each other. This study aims to compare the kinematics, repeatability, and reproducibility of five MFMs in the same experimental conditions. METHODS Eleven healthy males with a mean age of 26.5 years participated in this study. We created a merged 29-marker set including five MFMs: Oxford (OFM), modified Rizzoli (mRFM), DuPont (DFM), Milwaukee (MiFM), and modified Shriners Hospital for Children Greenville (mSHCG). Two operators applied the merged model to participants twice, and then we analysed two relative angles of three segments: shank-hindfoot (HF) and hindfoot-forefoot (FF). Coefficients of multiple correlation (CMC) and mean standard errors were used to assess repeatability and reproducibility, and statistical parametric mapping (SPM) of the t-value was employed to compare kinematics. RESULTS HF varus/valgus of the MiFM and mSHCG models, which rotated the segment according to radiographic or goniometric measurements during the reference frame construction, were significantly more repeatable and reproducible, compared to other models. They showed significantly more dorsiflexed HF and plantarflexed FF due to their static offset angles. DFM and mSHCG showed a greater range of motion (ROM), and some models had significantly different FF points of peak angle. CONCLUSIONS Under the same conditions, rotating the segment according to the appropriate offset angle obtained from radiographic or goniometric measurement increased reliability, but all MFMs had clinically acceptable reliability compared to previous studies. Moreover, in some models, especially HF varus/valgus, there were differences in ROM and points of peak angle even with no statistical difference in SPM curves. Therefore, based on the results of this study, clinicians and researchers involved in the evaluation of foot and ankle dysfunction need an understanding of the specific features of each MFM to make accurate decisions.
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Affiliation(s)
- Hyo Jeong Yoo
- Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-no, Jongno-gu, Seoul, South Korea
| | - Hye Sun Park
- Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-no, Jongno-gu, Seoul, South Korea
| | - Dong-Oh Lee
- Department of Orthopedic Surgery, SNU Seoul Hospital, Seoul, South Korea
| | - Seong Hyun Kim
- Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-no, Jongno-gu, Seoul, South Korea
| | - Gil Young Park
- Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-no, Jongno-gu, Seoul, South Korea
| | - Tae-Joon Cho
- Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-no, Jongno-gu, Seoul, South Korea.,Department of Orthopedic Surgery, Seoul National University College of Medicine, 101 Daehak-no, Jongno-gu, Seoul, South Korea
| | - Dong Yeon Lee
- Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-no, Jongno-gu, Seoul, South Korea. .,Department of Orthopedic Surgery, Seoul National University College of Medicine, 101 Daehak-no, Jongno-gu, Seoul, South Korea.
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12
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Comparison between the Rizzoli and Oxford foot models with independent and clustered tracking markers. Gait Posture 2022; 91:48-51. [PMID: 34649170 DOI: 10.1016/j.gaitpost.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 09/27/2021] [Accepted: 10/01/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The Rizzoli Foot Model (RFM) and Oxford Foot Model (OFM) are used to analyze segmented foot kinematics with independent tracking markers. Alternatively, rigid marker clusters can be used to improve markers' visualization and facilitate analyzing shod gait. RESEARCH QUESTION Are there differences in angles from the RFM and OFM, obtained with independent and clustered tracking markers, during the stance phase of walking? METHODS Walking kinematics of 14 non-disabled participants (25.2 years (SD 2.8)) were measured at self-selected speed. Rearfoot-shank and forefoot-rearfoot angles were measured from two models with two tracking methods: RFM, OFM, RFM-cluster, and OFM-cluster. In RFM-cluster and OFM-cluster, the rearfoot and forefoot tracking markers were rigidly clustered, fixed on rods' tips attached to a metallic base. Statistical Parametric Mapping (SPM) One-Way Repeated Measures ANOVAs and SPM Paired t-tests were used to compare waveforms. Coefficients of Multiple Correlation (CMC) quantified the similarity between waveforms. One-way Repeated Measures ANOVAs were conducted to compare the ranges of motion (ROMs), and pre-planned contrasts investigated differences between the models and tracking methods. Intraclass Correlation Coefficients (ICC) were computed to verify the similarity between ROMs. RESULTS Differences occurred mostly in small parts of the stance phase for the cluster vs. non-cluster comparisons and the RFM vs. OFM comparisons. ROMs were slightly different between the models and tracking methods in most comparisons. The curves (CMC ≥ 0.71) were highly similar between the models and tracking methods. The ROMs (ICC ≥ 0.67) were moderatetly to highly similar in most comparisons. RFM vs. RFM-cluster (forefoot-rearfoot angle - transverse plane), OFM vs. OFM-cluster and RFM vs. OFM (forefoot-rearfoot angle - frontal plane) were not similar (non-significant). SIGNIFICANCE Rigid clusters are an alternative for tracking rearfoot-shank and forefoot-rearfoot angles during the stance phase of walking. However, specific differences should be considered to contrast results from different models and tracking methods.
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13
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Understanding the role of foot biomechanics on regional foot orthosis deformation in flatfoot individuals during walking. Gait Posture 2022; 91:117-125. [PMID: 34673447 DOI: 10.1016/j.gaitpost.2021.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Foot orthoses (FOs) are one of the most common interventions to restore normal foot mechanics in flatfoot individuals. New technologies have made it possible to deliver customized FOs with complex designs for potentially better functionalities. However, translating the individuals' biomechanical needs into the design of customized FOs is not yet fully understood. RESEARCH QUESTION Our objective was to identify whether the deformation of customized FOs is related to foot kinematics and plantar pressure during walking. METHODS The kinematics of multi-segment foot and FOs contour were recorded together with plantar pressure in 17 flatfoot individuals while walking with customized FOs. The deformation of FOs surface was predicted from its contour kinematics using an artificial neural network. Plantar pressure map and deformation were divided into five anatomically based regions defined by the corresponding foot segments. Forward stepwise linear mixed models were built for each of the four gait phases to determine the feet-FOs interaction. RESULTS It was observed that some associations existed between foot kinematics and pressure with regional FOs deformation. From heel-strike to foot-flat, longitudinal arch angle was associated with FOs deformation in forefoot. From foot-flat to midstance, rearfoot eversion accounted for variation in the deformation of medial FOs regions, and forefoot abduction for the lateral regions. From midstance to heel-off, rearfoot eversion, longitudinal arch angle, and plantar pressure played significant role in deformation. Finally, from heel-off to toe-off, forefoot adduction affected the deformation of forefoot and midfoot. SIGNIFICANCE This study provides guidelines for designing customized FOs. Flatfoot individuals with excessive rearfoot eversion or very flexible medial arches require more support on medial FOs regions, while the ones with excessive forefoot abduction need the support on lateral regions. However, a compromise should be made between the level of support and the level of increase in plantar pressure to avoid stress on foot structures.
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14
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Caravaggi P, Rogati G, Leardini A, Ortolani M, Barbieri M, Spasiano C, Durante S, Matias AB, Taddei U, Sacco ICN. Accuracy and correlation between skin-marker based and radiographic measurements of medial longitudinal arch deformation. J Biomech 2021; 128:110711. [PMID: 34481280 DOI: 10.1016/j.jbiomech.2021.110711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 07/14/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
Static and dynamic measurements of the medial longitudinal arch (MLA) in the foot are critical across different clinical and biomechanical research fields. While MLA deformation can be estimated using skin-markers for gait analysis, the current understanding of the correlates between skin-marker based models and radiographic measures of the MLA is limited. This study aimed at assessing the correlation and accuracy of skin-marker based measures of MLA deformation with respect to standard clinical X-ray based measures, used as reference. 20 asymptomatic subjects without morphological alterations of the foot volunteered in the study. A lateral X-ray of the right foot of each subject was taken in monopodalic upright posture with and without a metatarsophalangeal-joint dorsiflexing wedge. MLA angle was estimated in the two foot postures and during gait using 16 skin-marker based models, which were established according to the marker set of a validated multi-segment foot kinematic protocol. The error of each model in tracking MLA deformation was assessed and correlated with respect to standard radiographic measurements. Estimation of MLA deformation was highly affected by the skin-marker models. Skin-marker models using the marker on the navicular tuberosity as apex of the MLA angle showed the smallest errors (about 2 deg) and the largest correlations (R = 0.64-0.65; p < 0.05) with respect to the radiographic measurements. According to the outcome of this study, skin-marker based definitions of the MLA angle using the navicular tuberosity as apex of the arch may provide a more accurate estimation of MLA deformation with respect to that from radiographic measures.
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Affiliation(s)
- Paolo Caravaggi
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giulia Rogati
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Alberto Leardini
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Maurizio Ortolani
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Chiara Spasiano
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Stefano Durante
- Nursing, Technical and Rehabilitation Assistance Service, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Alessandra B Matias
- Physical Therapy, Speech and Occupational Therapy Dept., School of Medicine, University of Sao Paulo, SP, Brazil
| | - Ulisses Taddei
- Physical Therapy, Speech and Occupational Therapy Dept., School of Medicine, University of Sao Paulo, SP, Brazil
| | - Isabel C N Sacco
- Physical Therapy, Speech and Occupational Therapy Dept., School of Medicine, University of Sao Paulo, SP, Brazil
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15
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Akhavanhezaveh A, Abbasi‐Kesbi R. Diagnosing gait disorders based on angular variations of knee and ankle joints utilizing a developed wearable motion sensor. Healthc Technol Lett 2021; 8:118-127. [PMID: 34584746 PMCID: PMC8450179 DOI: 10.1049/htl2.12015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/20/2021] [Accepted: 05/28/2021] [Indexed: 12/16/2022] Open
Abstract
Here, a sensory motion system is developed to diagnose gait disorders using the estimation of angular variations in the knee and ankle joints. The sensory system includes two transmitter sensors and a central node, where each transmitter comprises three sensors of accelerometer, gyroscopes, and magnetometer to estimate the angular movements in the ankle and knee joints. By using a proposed filter, the angular variation is estimated in a personal computer employing the raw data of the motion sensors that are sent by the central node. The obtained results of the presented filter in comparison to an actual reference illustrate that the root mean square error is less than 1.01, 1.34, and 1.61 degrees, respectively, for the angles of ϕ and θ and ψ that illustrate an improvement of 40% than the previous work. Moreover, a quantity value is defined based on the correlation between knee and ankle angles that show the amount of correctness in gating. Thus, the proposed system can be utilized for people who suffer problems in gait and help them to improve their movements.
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Affiliation(s)
| | - Reza Abbasi‐Kesbi
- MEMS & NEMS DepartmentFaculty of New Sciences and TechnologiesUniversity of TehranTehranIran
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16
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Chan PH, Stebbins J, Zavatsky AB. Efficacy of quantifying marker-cluster rigidity in a multi-segment foot model: a Monte-Carlo based global sensitivity analysis and regression model. Comput Methods Biomech Biomed Engin 2021; 25:308-319. [PMID: 34289759 DOI: 10.1080/10255842.2021.1954170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Marker-based clinical gait analysis and multi-segment foot models (MSFM) have been successfully used for the diagnosis and clinical management of various lower limb disorders. The accuracy and validity of the kinematics measured depend on the design of the model, as well as on the adherence to its inherent rigid body assumption. This study applies a Monte-Carlo based global sensitivity analysis to evaluate the efficacy of using 'rigid body error (σRBE)' in quantifying the rigidity of a MSFM marker-cluster. A regression model is proposed. It is concluded that σRBE is effective in quantifying rigidity.
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Affiliation(s)
- Po-Hsiang Chan
- Department of Engineering Science, University of Oxford, Oxford, UK
| | - Julie Stebbins
- Oxford Gait Laboratory, Nuffield Orthopaedic Centre NHS Trust, Oxford, UK
| | - Amy B Zavatsky
- Department of Engineering Science, University of Oxford, Oxford, UK
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17
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Schallig W, van den Noort JC, Maas M, Harlaar J, van der Krogt MM. Marker placement sensitivity of the Oxford and Rizzoli foot models in adults and children. J Biomech 2021; 126:110629. [PMID: 34320419 DOI: 10.1016/j.jbiomech.2021.110629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/04/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022]
Abstract
Understanding the effect of individual marker misplacements is important to improve the repeatability and aid to the interpretation of multi-segment foot models like the Oxford and Rizzoli Foot Models (OFM, RFM). Therefore, this study aimed to quantify the effect of controlled anatomical marker misplacement on multi-segment foot kinematics (i.e. marker placement sensitivity) as calculated by OFM and RFM in a range of foot sizes. Ten healthy adults and nine children were included. A combined OFM and RFM marker set was placed on their right foot and a static standing trial was collected. Each marker was replaced ± 10 mm in steps of 1 mm over the three axes of a foot coordinate system. For each replacement the change in segment orientation (tibia, hindfoot, midfoot, forefoot) was calculated with respect to the reference pose in which no markers were replaced. A linear fit was made to calculate the sensitivity of segment orientation to marker misplacement in °/mm. Additionally, the effect of foot size on the sensitivity was determined using linear regressions. For every foot segment of both models, at least one marker had a sensitivity ≥ 1.0°/mm. Highest values were found for the markers at the posterior aspect of the calcaneus in OFM (1.5°/mm) and the basis of the second metatarsal in RFM (1.4°/mm). Foot size had a small effect on 40% of the sensitivity values. This study identified markers of which consistent placement is critical to prevent clinically relevant errors (>5°). For more repeatable multi-segment models, the role of these markers within the models' definitions needs to be reconsidered.
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Affiliation(s)
- Wouter Schallig
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Radiology and Nuclear Medicine, Medical Imaging Quantification Center (MIQC), Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands.
| | - Josien C van den Noort
- Amsterdam UMC, University of Amsterdam, Radiology and Nuclear Medicine, Medical Imaging Quantification Center (MIQC), Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - Mario Maas
- Amsterdam UMC, University of Amsterdam, Radiology and Nuclear Medicine, Medical Imaging Quantification Center (MIQC), Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - Jaap Harlaar
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands; Department of Orthopedics and Sports Medicine, ErasmusMC, Rotterdam, the Netherlands
| | - Marjolein M van der Krogt
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands
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18
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Desmyttere G, Hajizadeh M, Bleau J, Leteneur S, Begon M. Anti-pronator components are essential to effectively alter lower-limb kinematics and kinetics in individuals with flexible flatfeet. Clin Biomech (Bristol, Avon) 2021; 86:105390. [PMID: 34044295 DOI: 10.1016/j.clinbiomech.2021.105390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/14/2021] [Accepted: 05/19/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Foot orthoses are commonly used to correct for foot alterations and especially address excessive foot pronation in individuals with flatfeet. In recent years, 3D printing has taken a key place in orthotic manufacturing processes as it offers more options and can be patient specific. Hence, the purpose of this study was to evaluate whether stiffness of 3D printed foot orthoses and a newly designed rearfoot posting have an effect on lower limb kinematics and kinetics in individuals with flatfeet. METHODS Nineteen patients with flexible flatfeet were provided two pairs of customized 3D printed ¾ length orthotics. Foot orthoses were of different stiffness and could feature a rearfoot posting, consisting of 2-mm carbon fiber plate. Lower limb kinematics and kinetics were computed using a multi-segment foot model. One-way ANOVAs using statistical non-parametric mapping, refined by effect sizes, were performed to determine the magnitude of the effect between conditions. FINDINGS Foot orthoses stiffness had little effect on midfoot and forefoot biomechanics. Reductions in midfoot eversion and forefoot abduction were observed during short periods of stance with rigid foot orthoses. Adding the posting had notable effects on rearfoot kinematics and on the ankle and knee kinetics in the frontal plane; it significantly reduced the eversion angle and inversion moment at the ankle, and increased the knee abduction moment. INTERPRETATION Using an anti-pronator component is more effective than increasing foot orthoses stiffness to observe a beneficial impact of foot orthoses on the control of excessive foot pronation in individuals with flatfeet.
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Affiliation(s)
- Gauthier Desmyttere
- École de Kinésiologie et des Sciences de l'Activité Physique, Université de Montréal, Campus Laval, 1700 rue Jacques Tétreault, Laval, QC H7N 0B6, Canada.
| | - Maryam Hajizadeh
- Institut de Génie Biomédical, Université de Montréal, Campus Laval, 1700 rue Jacques Tétreault, Laval, QC H7N 0B6, Canada
| | - Jacinte Bleau
- Institut de Génie Biomédical, Université de Montréal, Campus Laval, 1700 rue Jacques Tétreault, Laval, QC H7N 0B6, Canada
| | - Sébastien Leteneur
- Université Polytechnique Hauts-de-France, UMR 8201 - LAMIH - Laboratoire d'Automatique de Mécanique et d'Informatique Industrielles et Humaines, F-59313 Valenciennes, France
| | - Mickael Begon
- École de Kinésiologie et des Sciences de l'Activité Physique, Université de Montréal, Campus Laval, 1700 rue Jacques Tétreault, Laval, QC H7N 0B6, Canada; Laboratoire Orthopédique Médicus, 2520 Boul. St-Joseph, Montréal, QC H1Y 2A2, Canada
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