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Zhang Z, Xu D, Gao X, Liang M, Baker JS, Gu Y. The Effect of Different Degrees of Ankle Dorsiflexion Restriction on the Biomechanics of the Lower Extremity in Stop-Jumping. Appl Bionics Biomech 2024; 2024:9079982. [PMID: 39234300 PMCID: PMC11374426 DOI: 10.1155/2024/9079982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 07/22/2024] [Indexed: 09/06/2024] Open
Abstract
Purpose The functional status of the ankle joint is critical during dynamic movements in high-intensity sports like basketball and volleyball, particularly when performing actions such as stopping jumps. Limited ankle dorsiflexion is associated with increased injury risk and biomechanical changes during stop-jump tasks. Therefore, this study aims to investigate how restricting ankle dorsiflexion affects lower extremity biomechanics during the stop-jump phase, with a focus on the adaptive changes that occur in response to this restriction. Initially, 18 participants during stop-jumping with no wedge plate (NW), 10° wedge plate (10 W), and 20° wedge plate (20 W) using dominant leg data were collected to explore the relationship between limiting ankle mobility and lower extremity biomechanics. Following this, a musculoskeletal model was developed to simulate and calculate biomechanical data. Finally, one-dimensional parametric statistical mapping (SPM1D) was utilized to evaluate between-group variation in outcome variables using a one-way repeated measures analysis of variance (ANOVA). Results As the ankle restriction angle increased, knee external rotation angles, knee extension angular velocities, hip extension angle, and angular velocity increased and were significantly different at different ankle restriction angles (p < 0.001 and p=0.001), coactivation of the peripatellar muscles (BF/RF and BF/VM) increased progressively, and patellofemoral joint contact force (PTF) increased progressively during the 3%-8% phase (p=0.015). These results highlight the influence of ankle joint restriction on lower limb kinematics and patellofemoral joint loading during the stop-jump maneuver. Conclusion As the angle of ankle restriction increased, there was an increase in coactivation of the peripatellar muscles and an increase in PTF, possibly because a person is unable to adequately adjust their body for balance when the ankle valgus angle is restricted. The increased coactivation of the peripatellar muscles and increased patellofemoral contact force may be a compensatory response to the body's adaptation to balance adjustments.
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Affiliation(s)
- Zanni Zhang
- Faculty of Sport Science Ningbo University, Ningbo, China
| | - Datao Xu
- Faculty of Sport Science Ningbo University, Ningbo, China
- Faculty of Engineering University of Pannonia, Veszprem, Hungary
| | - Xiangli Gao
- Faculty of Sport Science Ningbo University, Ningbo, China
- Department of Radiology Ningbo No. 2 Hospital, Ningbo, China
| | - Minjun Liang
- Faculty of Sport Science Ningbo University, Ningbo, China
| | - Julien S Baker
- Faculty of Sport Science Ningbo University, Ningbo, China
- Department of Radiology Ningbo No. 2 Hospital, Ningbo, China
| | - Yaodong Gu
- Faculty of Sport Science Ningbo University, Ningbo, China
- Department of Radiology Ningbo No. 2 Hospital, Ningbo, China
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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 PMCID: PMC11296718 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 MedicinePeking University Third HospitalInstitute of Sports Medicine of Peking UniversityBeijing Key Laboratory of Sports InjuriesEngineering Research Center of Sports Trauma Treatment Technology and DevicesMinistry of EducationBeijingChina
- Tianjin Key Laboratory of Exercise Physiology and Sports MedicineInstitute of Sport, Exercise & HealthTianjin University of SportTianjinChina
| | - Zhengye Ma
- Department of Sports MedicinePeking University Third HospitalInstitute of Sports Medicine of Peking UniversityBeijing Key Laboratory of Sports InjuriesEngineering Research Center of Sports Trauma Treatment Technology and DevicesMinistry of EducationBeijingChina
| | - Nan Yang
- Department of Sports MedicinePeking University Third HospitalInstitute of Sports Medicine of Peking UniversityBeijing Key Laboratory of Sports InjuriesEngineering Research Center of Sports Trauma Treatment Technology and DevicesMinistry of EducationBeijingChina
- Tianjin Key Laboratory of Exercise Physiology and Sports MedicineInstitute of Sport, Exercise & HealthTianjin University of SportTianjinChina
| | - Si Zhang
- Department of Sports MedicinePeking University Third HospitalInstitute of Sports Medicine of Peking UniversityBeijing Key Laboratory of Sports InjuriesEngineering Research Center of Sports Trauma Treatment Technology and DevicesMinistry of EducationBeijingChina
| | - Haitao Shi
- Department of Sports MedicinePeking University Third HospitalInstitute of Sports Medicine of Peking UniversityBeijing Key Laboratory of Sports InjuriesEngineering Research Center of Sports Trauma Treatment Technology and DevicesMinistry of EducationBeijingChina
- Tianjin Key Laboratory of Exercise Physiology and Sports MedicineInstitute of Sport, Exercise & HealthTianjin University of SportTianjinChina
| | - Hua Zhang
- Research Center of Clinical EpidemiologyPeking University Third HospitalBeijingChina
| | - Shuang Ren
- Department of Sports MedicinePeking University Third HospitalInstitute of Sports Medicine of Peking UniversityBeijing Key Laboratory of Sports InjuriesEngineering Research Center of Sports Trauma Treatment Technology and DevicesMinistry of EducationBeijingChina
| | - Hongshi Huang
- Department of Sports MedicinePeking University Third HospitalInstitute of Sports Medicine of Peking UniversityBeijing Key Laboratory of Sports InjuriesEngineering Research Center of Sports Trauma Treatment Technology and DevicesMinistry of EducationBeijingChina
- Tianjin Key Laboratory of Exercise Physiology and Sports MedicineInstitute of Sport, Exercise & HealthTianjin University of SportTianjinChina
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Aquino MRC, Resende RA, Van Emmerik R, Souza TR, Fonseca ST, Kirkwood RN, Ocarino JM. Influence of reduced passive ankle dorsiflexion range of motion on lower limb kinetics and stiffness during gait. Gait Posture 2024; 109:147-152. [PMID: 38309125 DOI: 10.1016/j.gaitpost.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 11/24/2023] [Accepted: 01/17/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND The ankle dorsiflexion range of motion (ADF-ROM) during single support phase allows elastic energy storage in the calcaneal tendon, contributing to advance the body forward. Reduced ADF-ROM may influence lower limb kinetics and stiffness. RESEARCH QUESTION What is the influence of reduced passive ADF-ROM on lower limb internal moments and stiffness during gait? METHODS Thirty-two participants, classified into two groups according to passive ADF-ROM (smaller than 10° and greater than 15°), were submitted to gait assessment at self-selected speed with a force platform and a three-dimensional motion analysis system. Statistical parametrical mapping (SPM) analyses were used to compare the lower limbs' internal moments between groups. Independent t-tests analyzed the differences between groups on lower limb stiffness during gait. RESULTS The lower ADF-ROM group had greater knee flexor moment (terminal stance and push-off), greater ankle abductor (i.e., shank internal rotator) moment in terminal stance and greater knee internal rotator moment in mid to terminal stance. The lower ADF-ROM group also had higher lower limb stiffness during gait. SIGNIFICANCE Individuals with reduced passive ADF-ROM had greater lower limb stiffness and adopted a gait pattern with increased knee and ankle moments, suggesting increased loading at these joints.
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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
| | - Richard Van Emmerik
- University of Massachusetts Amherst, Department of Kinesiology, 30 Eastman Lane, 01003 Amherst, MA, USA
| | - 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
| | - 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
| | - Renata N Kirkwood
- 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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Rao Y, Yang N, Gao T, Zhang S, Shi H, Lu Y, Ren S, Huang H. Effects of peak ankle dorsiflexion angle on lower extremity biomechanics and pelvic motion during walking and jogging. Front Neurol 2024; 14:1269061. [PMID: 38362013 PMCID: PMC10867967 DOI: 10.3389/fneur.2023.1269061] [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: 07/29/2023] [Accepted: 10/17/2023] [Indexed: 02/17/2024] Open
Abstract
Objective Ankle dorsiflexion during walking causes the tibia to roll forward relative to the foot to achieve body forward. Individuals with ankle dorsiflexion restriction may present altered movement patterns and cause a series of dysfunction. Therefore, the aim of this research was to clearly determine the effects of peak ankle dorsiflexion angle on lower extremity biomechanics and pelvic motion during walking and jogging. Method This study involved 51 subjects tested for both walking and jogging. The motion capture system and force measuring platforms were used to synchronously collect kinematics and kinetics parameters during these activities. Based on the peak ankle dorsiflexion angle during walking, the 51 subjects were divided into a restricted group (RADF group, angle <10°) and an ankle dorsiflexion-unrestricted group (un-RADF group, angle >10°). Independent-Sample T-tests were performed to compare the pelvic and lower limb biomechanics parameters between the groups during walking and jogging test on this cross-sectional study. Results The parameters that were significantly smaller in the RADF group than in the un-RADF group at the moment of peak ankle dorsiflexion in the walking test were: ankle plantar flexion moment (p < 0.05), hip extension angle (p < 0.05), internal ground reaction force (p < 0.05), anterior ground reaction force (p < 0.01), pelvic ipsilateral tilt angle (p < 0.05). In contrast, the external knee rotation angle was significantly greater in the RADF group than in the un-RADF group (p < 0.05). The parameters that were significantly smaller in the RADF group than in the un-RADF group at the moment of peak ankle dorsiflexion in the jogging test were: peak ankle dorsiflexion angle (p < 0.01); the anterior ground reaction force (p < 0.01), the angle of pelvic ipsilateral rotation (p < 0.05). Conclusion This study shows that individuals with limited ankle dorsiflexion experience varying degrees of altered kinematics and dynamics in the pelvis, hip, knee, and foot during walking and jogging. Limited ankle dorsiflexion alters the movement pattern of the lower extremity during walking and jogging, diminishing the body's ability to propel forward, which may lead to higher injury risks.
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Affiliation(s)
- Yi Rao
- Department of Rehabilitation, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- 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
- College of Exercise and Health Sciences, Tianjin University of Sport, Tianjin, China
| | - 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
- College of Exercise and Health Sciences, 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
- College of Exercise and Health Sciences, Tianjin University of Sport, Tianjin, China
| | - Yiqun Lu
- 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
| | - 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
- College of Exercise and Health Sciences, Tianjin University of Sport, Tianjin, China
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Welte L, Holowka NB, Kelly LA, Arndt A, Rainbow MJ. Mobility of the human foot's medial arch helps enable upright bipedal locomotion. Front Bioeng Biotechnol 2023; 11:1155439. [PMID: 37324435 PMCID: PMC10264861 DOI: 10.3389/fbioe.2023.1155439] [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: 01/31/2023] [Accepted: 04/03/2023] [Indexed: 06/17/2023] Open
Abstract
Developing the ability to habitually walk and run upright on two feet is one of the most significant transformations to have occurred in human evolution. Many musculoskeletal adaptations enabled bipedal locomotion, including dramatic structural changes to the foot and, in particular, the evolution of an elevated medial arch. The foot's arched structure has previously been assumed to play a central role in directly propelling the center of mass forward and upward through leverage about the toes and a spring-like energy recoil. However, it is unclear whether or how the plantarflexion mobility and height of the medial arch support its propulsive lever function. We use high-speed biplanar x-ray measurements of foot bone motion on seven participants while walking and running and compare their motion to a subject-specific model without arch recoil. We show that regardless of intraspecific differences in medial arch height, arch recoil enables a longer contact time and favorable propulsive conditions at the ankle for walking upright on an extended leg. The generally overlooked navicular-medial cuneiform joint is primarily responsible for arch recoil in human arches. The mechanism through which arch recoil enables an upright ankle posture may have helped drive the evolution of the longitudinal arch after our last common ancestor with chimpanzees, who lack arch plantarflexion mobility during push-off. Future morphological investigations of the navicular-medial cuneiform joint will likely provide new interpretations of the fossil record. Our work further suggests that enabling medial arch recoil in footwear and surgical interventions may be critical for maintaining the ankle's natural propulsive ability.
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Affiliation(s)
- Lauren Welte
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada
| | - Nicholas B Holowka
- Department of Anthropology, University at Buffalo, Buffalo, NY, United States
| | - Luke A Kelly
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Anton Arndt
- The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
- Karolinska Institute, Stockholm, Sweden
| | - Michael J Rainbow
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada
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6
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Lim W. Acute effect of diagonal stretching using the posterior oblique sling system on contralateral ankle dorsiflexion. J Back Musculoskelet Rehabil 2023; 36:245-252. [PMID: 36120769 DOI: 10.3233/bmr-220073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND A significant increase in the dorsiflexion range of motion (DFROM) after calf muscle stretching has been widely studied. However, it has been shown that the upper body is connected to the ankle joint by passive connective tissues. OBJECTIVE The purpose of this study was to examine the effect of upper-back stretching on the mobility of the contralateral ankle. METHODS In the supine position, DFROM in the contralateral leg was measured. In the sitting position with and without trunk rotation, DFROM was measured in both legs. In the sitting position with trunk rotation, dorsiflexion was measured only in the contralateral leg. Static diagonal stretching combining trunk rotation with slight trunk flexion was performed in the sitting position with a neutral pelvis. RESULTS After stretching, DFROM in contralateral and ipsilateral legs were measured in the sitting position with a neutral pelvis. In the contralateral leg, significant differences in ΔDFROM were observed between the sitting position with trunk rotation and the supine position and between the sitting position with trunk rotation and the sitting position after stretching. CONCLUSION In clinical settings, diagonal stretching of the unilateral posterior trunk causes a significant increase in the DFROM of the contralateral lower limb.
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Affiliation(s)
- Wootaek Lim
- Department of Physical Therapy, College of Health and Welfare, Woosong University, 171 Dongdaejeon-ro, Dong-gu, Daejeon, Korea.,Woosong Institute of Rehabilitation Science, Woosong University, 171 Dongdaejeon-ro, Dong-gu, Daejeon, Korea
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7
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Ghorbani M, Eliasi H, Yaali R, Letafatkar A, Sadeghi H. Can different training methods reduce the kinematic risk factors of ACL injuries in children? J Biomech 2023; 146:111401. [PMID: 36493530 DOI: 10.1016/j.jbiomech.2022.111401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/04/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
According to the research, a lack of neuromuscular control is a major cause of non-contact anterior cruciate ligament (ACL) injury during locomotion. This study aimed to determine the influence of various prescriptive and Constrained Led Approach (CLA) training approaches on lower extremity kinematics and stride length in children aged 3-5 years old while walking and running. Thirty-six children with a mean age of 4.79 years were separated into three groups: 1- prescriptive training group (n = 10), 2- CLA training group (n = 11), and 3- Control group (n = 10). The kinematics of the hip, knee and ankle joints in the sagittal plane at the moment of heel contact and toe-off were recorded before and after six weeks of intervention. According to the MANOVA, there was no statistically significant difference between the two training techniques in the joint angles at heel contact and toe-off during walking and running after intervention (p ≥ 0.05). However, there was a significant difference in the kinematic characteristics of walking and running between the training and the control groups (p ≤ 0.05). The two training techniques showed a statistically significant difference in stride length during running (p ≤ 0.05). The results indicated that prescriptive and CLA training are effective at altering the kinematics and distance factors underlying children's walking and running abilities.
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Affiliation(s)
- Maryam Ghorbani
- Department of Motor Behavior, Faculty of Physical Education and Sport Sciences, Kharazmi University of Tehran, Tehran, Iran
| | - Hosna Eliasi
- Department of Motor Behavior, Faculty of Physical Education and Sport Sciences, Kharazmi University of Tehran, Tehran, Iran
| | - Rasoul Yaali
- Department of Motor Behavior, Faculty of Physical Education and Sport Sciences, Kharazmi University of Tehran, Tehran, Iran.
| | - Amir Letafatkar
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education and Sport Sciences, Kharazmi University of Tehran, Tehran, Iran
| | - Hassan Sadeghi
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education and Sport Sciences, Kharazmi University of Tehran, Tehran, Iran
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Nitta Y, Seki H, Suda Y, Tanabe R, Tsuchiya R, Nagashima M, Ishii K. Isolated Talonavicular Arthrodesis for Traumatic Talonavicular Arthritis: Report of 2 Cases With Gait Analyses. Foot Ankle Spec 2022; 15:163-170. [PMID: 34247542 DOI: 10.1177/19386400211030132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Isolated talonavicular arthrodesis is one of the surgical procedures for patients with talonavicular arthritis. However, the 3-dimensional kinematic behavior of the hip, knee, and foot/ankle complex during walking after the arthrodesis remains unclear. The clinical outcomes and gait analyses of 2 cases who underwent isolated arthrodesis for talonavicular osteoarthritis with chronic dislocated navicular fracture are presented. Gait analysis was carried out in both cases 1 year after surgery to clarify the side-to-side differences in the ranges of motion of the hip, knee, and foot/ankle complex during walking. Both cases showed good clinical results and radiographic bone union. The kinematic data of the gait analyses showed considerable restriction in the range of motion of the ankle in all 3-dimensional planes for the fused foot compared with the contralateral side. Additionally, hyperextension of the knee in the late stance of gait on the operated side was observed in both cases. When talonavicular arthrodesis was performed for talonavicular osteoarthritis with chronic dislocated navicular fracture, postoperative generalized stiffness of the ankle and future disorder of the knee should be considered.Levels of Evidence: Level V: Case report.
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Affiliation(s)
- Yuina Nitta
- Department of Rehabilitation, International University of Health and Welfare (IUHW), Mita Hospital, Minato-ku, Tokyo, Japan
| | - Hiroyuki Seki
- Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW), Mita Hospital, Minato-ku, Tokyo, Japan.,Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Chiba, Japan.,Department of Orthopaedic Surgery, Ogikubo Hospital, Tokyo, Japan
| | - Yasunori Suda
- Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW), Mita Hospital, Minato-ku, Tokyo, Japan.,Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Chiba, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Shioya Hospital, Tochigi, Japan
| | - Rie Tanabe
- Department of Rehabilitation, International University of Health and Welfare (IUHW), Mita Hospital, Minato-ku, Tokyo, Japan
| | - Risa Tsuchiya
- Department of Rehabilitation, International University of Health and Welfare (IUHW), Mita Hospital, Minato-ku, Tokyo, Japan
| | - Masaki Nagashima
- Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW), Mita Hospital, Minato-ku, Tokyo, Japan.,Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Chiba, Japan
| | - Ken Ishii
- Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW), Mita Hospital, Minato-ku, Tokyo, Japan.,Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Chiba, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Narita Hospital, Chiba, Japan
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Bae Y, Park D. Immediate Effect of Lower-Leg Kinesio Taping on Ankle Dorsiflexion and Gait Parameters in Chronic Stroke with Foot Drop. J Stroke Cerebrovasc Dis 2022; 31:106425. [PMID: 35255287 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 02/07/2022] [Accepted: 02/17/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Kinesio taping (KT) and proprioceptive neuromuscular facilitation (PNF) are interventions mainly used in clinical settings to improve gait after stroke. Lower-leg KT using the concept of PNF (PNF-KT) has been shown to enhance the recovery of gait speed in patients with stroke. But, the effect of PNF-KT on the ankle movement and gait parameters in stroke patients is unclear. We aimed to investigate the immediate effects of PNF-KT on ankle dorsiflexion range of motion (DF-ROM) and gait parameters in patients with stroke with foot drop. MATERIALS AND METHODS For the A-KT condition, tape was attached to the gastrocnemius and tibialis anterior muscles, and tape for eversion was attached. In the PNF-KT condition, tape was attached to the tibialis anterior, extensor hallucis and digitorum muscles. Ankle movement was measured as the ankle DF-ROM using an iSEN system. Gait ability was assessed using the GAITRite system. The measured gait variables were gait velocity, cadence, and step length (both sides). RESULTS A-KT and PNF-KT significantly improved the ankle DF-ROM, gait velocity, cadence, and the affected- and unaffected-side step length compared to that with no taping. Moreover, PNF-KT significantly increased the ankle DF-ROM, gait velocity, cadence, and the affected- and unaffected-side step length compared to that with A-KT. CONCLUSIONS PNF-KT applied to the affect side improved ankle DF-ROM and gait parameters in hemiplegic stroke patients than no taping, A-KT. Lower-leg PNF-KT may be a useful intervention in a rehabilitation program to improve ankle DF-ROM and gait parameters in chronic stroke patients with foot drop in clinical settings.
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Affiliation(s)
- Youngsook Bae
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Republic of Korea
| | - Donghwan Park
- Department of Physical Therapy, Graduate School, College of Health Sciences, Kyungnam University, Changwon, Republic of Korea.
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10
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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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Evaluating the Effectiveness of Soft Tissue Therapy in the Treatment of Disorders and Postoperative Conditions of the Knee Joint-A Systematic Review. J Clin Med 2021; 10:jcm10245944. [PMID: 34945240 PMCID: PMC8704673 DOI: 10.3390/jcm10245944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 11/17/2022] Open
Abstract
The term "soft tissue therapy" (STT) refers to mechanical methods of treatment involving passive kneading, pressing and stretching of pathologically tense tissues in supporting the process of recovery after surgery or trauma to the musculoskeletal system. The objective of this study was to review current scientific reports evaluating the effectiveness of the use of STT in patients with diseases or after surgical procedures of the knee joint. A systematic search of the popular scientific databases PubMed, Scopus and Embase was performed from inception to 15 October 2021. Eight articles met eligibility criteria and were included in the review. Six papers were related to disorders of the knee joint, while the remaining two studies were related to dysfunctions associated with the conditions after surgical intervention. The findings presented confirmed the effectiveness of STT in orthopaedic patients who showed an increase in lower limb functional parameters. The research has shown that the use of various methods of STT has a significant impact on increasing muscle activity and flexibility as well as increasing the range of motion in the knee joint. The physiotherapeutic methods used had a significant impact on reducing pain and increasing physical function and quality of life. The techniques used reduced the time to descend stairs in patients with knee osteoarthritis. This review summarises the effectiveness of STT as an important form of treatment for orthopaedic patients with various knee joint dysfunctions.
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Abstract
Abstract
Study aim: To investigate the effect of wearing ski boots on kinematic and kinetic parameters of lower limbs during gait. Furthermore, loads in lower limb joints were assessed using the musculoskeletal model.
Material and methods: The study examined 10 healthy women with shoe size 40 (EUR). Kinematic and kinetic data of walking in ski boots and barefoot were collected using a Vicon system and Kistler plates. A musculoskeletal model derived from AnyBody Modeling System was used to calculate joint reaction forces.
Results: Wearing ski boots caused the range of motion in the knee joint to be significantly smaller and the hip joint to be significantly larger. Muscle torques were significantly greater in walking in ski boots for the knee and hip joints. Wearing ski boots reduced the reaction forces in the lower limb joints by 18% for the ankle, 16% for the knee, and 39% for the hip.
Conclusions: Ski boot causes changes in the ranges of angles in the lower limb joints and increases muscle torques in the knee and hip joints but it does not increase the load on the joints. Walking in a ski boot is not destructive in terms of forces acting in the lower limb joints.
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Li Y, Yang X, Zhou Y, Chen J, Du M, Yang Y. Adaptive Stimulation Profiles Modulation for Foot Drop Correction Using Functional Electrical Stimulation: A Proof of Concept Study. IEEE J Biomed Health Inform 2021; 25:59-68. [PMID: 32340970 DOI: 10.1109/jbhi.2020.2989747] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Functional electrical stimulation (FES) provides an effective way for foot drop (FD) correction. To overcome the redundant and blind stimulation problems in the state-of-the-art methods, this study proposes a closed-loop scheme for an adaptive electromyography (EMG)-modulated stimulation profile. The developed method detects real-time angular velocity during walking. It provides feedbacks to a long short-term memory (LSTM) neural network for predicting synchronous tibialis anterior (TA) EMG. Based on the prediction, it modulates the stimulation intensity, taking into account of the subject-specific dead zone and saturation of the electrically evoked activation. The proposed method is tested on ten able-bodied participants and six FD subjects as proof of concept. The experimental results show that the proposed method can successfully induce the dorsiflexion of the ankle joint, and generate an activation pattern similar to a natural gait, with the mean Correlation Coefficient of 0.9021. Thus, the proposed method has the potential to help patients to retrieve normal gait.
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Implementing a Protocol of Ankle ROM Goniometry Measurement in the Neuroscience ICU. JOURNAL OF ACUTE CARE PHYSICAL THERAPY 2020. [DOI: 10.1097/jat.0000000000000142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hickey B, Dalmau-Pastor M, Karlsson J, Calder J. Hindfoot endoscopic release of the posterior ankle capsuloligamentous structures improves ankle dorsiflexion range, function and pain in patients with painful limitation of ankle dorsiflexion. J ISAKOS 2020. [DOI: 10.1136/jisakos-2019-000338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ObjectiveTo evaluate the effect of arthroscopic release of the posterior capsuloligamentous structures on ankle dorsiflexion and function in patients with painful limitation of ankle dorsiflexion.MethodsA prospective consecutive case series of 13 adult patients with painful limitation of ankle dorsiflexion were included. None had clinically relevant gastrocnemius, soleus or Achilles contracture. Patients with anterior bony impingement or ankle degeneration on CT scan were excluded. All patients underwent combined anterior and posterior ankle arthroscopies with resection of posterior capsuloligamentous structures and the posterior fibulotalocalcaneal ligament. Ankle range of motion was assessed 2 years postoperatively. Foot and Ankle Outcome Scores (FAOS) were used to assess functional outcome.ResultsThe median patient age at surgery was 26 years (range 19–44). At 2 years postsurgery, the ankle dorsiflexion range had increased by 15 degrees (range 0–25, p<0.0001). FAOSs completed at a median of 44 months postsurgery (range 26–72) significantly improved. Median improvements were 19 points for pain (range 6–67, p=0.0004), 14 points for symptoms (range 0–36, p=0.0005), 15 points for activities of daily living (range 6–35, p<0.0001), 45 points for sport (range 20–55, p<0.0001) and 50 points for quality of life (range 13–62, p<0.0001).ConclusionsHindfoot endoscopic release of the posterior ankle structures, including the posterior fibulotalocalcaneal ligament, is an effective technique for improving ankle dorsiflexion range in patients with painful limitation of ankle dorsiflexion.Level of evidenceIV.
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Rowlett CA, Hanney WJ, Pabian PS, McArthur JH, Rothschild CE, Kolber MJ. Efficacy of instrument-assisted soft tissue mobilization in comparison to gastrocnemius-soleus stretching for dorsiflexion range of motion: A randomized controlled trial. J Bodyw Mov Ther 2019; 23:233-240. [PMID: 31103101 DOI: 10.1016/j.jbmt.2018.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 01/01/2018] [Accepted: 02/05/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To determine the efficacy of IASTM of the gastrocnemius-soleus complex in comparison to a traditional stretching intervention on dorsiflexion ROM. METHODS Sixty healthy participants were randomly allocated to one of 3 groups: IASTM (n = 20), stretching (n = 20), or control group (n = 20). The dependent variables for this study was dorsiflexion range of motion (ROM) via three measurement methods which included Modified root position 1- knee extended (MRP1), Modified root position 2- knee flexed (MRP2), and weight bearing lunge test (WBLT). A multivariate analysis of variance (MANOVA) was utilized to analyze the ROM differences between the groups (IASTM, stretching, and control groups), with a post-hoc Tukey and pairwise least significant difference tests to assess individual pairwise differences between the groups. RESULTS The MANOVA found significant ROM differences between the three intervention groups (F6,110 = 2.40, p = .032). Statistically significant differences were identified between both the IASTM and control as well as the stretching and control group through the WBLT and MRP2 assessments, but not in the MRP1 assessment. Further, there was no statistically significant difference between the IASTM and stretching groups using any of the three methods. CONCLUSION A single session of IASTM or stretching increased ankle dorsiflexion ROM in WBLT and MRP2. No significant difference was noted in the MRP1. Both IASTM and stretching appear to have a greater effect on soleus muscle flexibility as evidenced by ROM gains measured with the knee in a flexed position. No clinically significant difference was identified between the intervention groups in weight-bearing conditions; thus empowering patients with the use of self-stretching would seemingly be reasonable and efficient. Combined effects of stretching and IASTM warrant further investigation for increasing dorsiflexion range of motion as a summative effect is unknown.
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Affiliation(s)
- Carrie A Rowlett
- University of Central Florida, Department of Health Professions, USA
| | - William J Hanney
- University of Central Florida, Department of Health Professions, USA.
| | - Patrick S Pabian
- University of Central Florida, Department of Health Professions, USA
| | - Jordon H McArthur
- University of Central Florida, Department of Health Professions, USA
| | | | - Morey J Kolber
- Nova Southeastern University, Department of Physical Therapy, USA
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Capobianco RA, Mazzo MM, Enoka RM. Self-massage prior to stretching improves flexibility in young and middle-aged adults. J Sports Sci 2019; 37:1543-1550. [PMID: 30714484 DOI: 10.1080/02640414.2019.1576253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We examined the influence of stretching alone (SS) or combined with self-massage (SM) on maximal ankle dorsiflexion angle, maximal voluntary contraction (MVC) torque and calf muscle activity, and subcutaneous tissue thickness in 15 young (25 ± 3 years) and 15 middle-aged (45 ± 5 years) adults. Participants performed two sessions of calf muscle stretches (3x 30-s stretches, 30-s rest): stretch after a 60-s control condition (SS) and stretch after 60 s of self-massage with therapy balls (SM). Evaluations were performed before and 5 min after the intervention. Linear mixed effects model revealed no main effect for age on ROM or MVC and significant main effects for treatment and time. Change in ankle angle was greater after SM: SS = 3.1 ± 2°, SM = 6.2 ± 3.3° (Hedges' g = 0.98, p < 0.001). Similar results were observed for MVC torque: SS = -4 ± 16%, SM = 12 ± 16% (Hedges' g = 0.97, p = 0.0001). Changes in MVC torque and absolute EMG amplitude were correlated, but subcutaneous tissue thickness was not altered by treatment. The gains in ROM were more pronounced in less flexible middle-aged adults, underscoring the need to include flexibility exercises in their training.
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Affiliation(s)
- Robyn A Capobianco
- a Neurophysiology of Movement Laboratory, Department of Integrative Physiology , University of Colorado , Boulder , CO , USA
| | - Melissa M Mazzo
- a Neurophysiology of Movement Laboratory, Department of Integrative Physiology , University of Colorado , Boulder , CO , USA
| | - Roger M Enoka
- a Neurophysiology of Movement Laboratory, Department of Integrative Physiology , University of Colorado , Boulder , CO , USA
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Mattock J, Steele JR, Mickle KJ. A protocol to prospectively assess risk factors for medial tibial stress syndrome in distance runners. BMC Sports Sci Med Rehabil 2018; 10:20. [PMID: 30479774 PMCID: PMC6251115 DOI: 10.1186/s13102-018-0109-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 11/05/2018] [Indexed: 12/25/2022]
Abstract
Background Medial tibial stress syndrome (MTSS) is a lower leg injury with a reported incidence rate of up to 35% in active individuals. Although numerous prospective studies have tried to identify risk factors for developing MTSS, managing the syndrome remains difficult. One risk factor yet to be extensively explored in MTSS development is reduced lower leg girth. Further investigation of reduced lower leg girth is required due to the important role lower leg musculature plays in attenuating ground reaction forces during the gait cycle. Therefore, the primary aim of this study is to ascertain whether lower leg muscle morphology and function contribute to the development of MTSS. Our ultimate aim is to identify potential risk factors for MTSS that can be targeted in future studies to better manage the injury or, preferably, prevent individuals developing MTSS. Methods This study will be prospective in design and will recruit asymptomatic distance runners. All participants will be tested at base line and participants will have their training data longitudinally tracked over the following 12 months to assess any individuals who develop MTSS symptoms. At base line, outcome measures will include bilateral measures of lower limb anthropometry; cross sectional area (CSA) and thickness of the tibialis anterior, peroneals, flexor digitorum longus, flexor hallucis longus and thickness of soleus, medial and lateral head of gastrocnemius. Tibial bone speed of sound, ankle dorsiflexion range of motion, strength of the six previously described muscles, foot alignment and ankle plantar flexor endurance will also be assessed. Participants will also complete a treadmill running protocol where three-dimensional kinematics, plantar pressure distribution and electromyography data will be collected. Discussion This study will aim to identify characteristics of individuals who develop MTSS and, in turn, identify modifiable risk factors that can be targeted to prevent individuals developing this injury.
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Affiliation(s)
- Joshua Mattock
- 1Biomechanics Research Laboratory, University of Wollongong, Wollongong, NSW Australia
| | - Julie R Steele
- 1Biomechanics Research Laboratory, University of Wollongong, Wollongong, NSW Australia
| | - Karen J Mickle
- 2Institute of Health and Sport, Victoria University, Melbourne, VIC Australia
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Kondo H. Changes in the Ground Reaction Force, Lower-Limb Muscle Activity, and Joint Angles in Athletes with Unilateral Ankle Dorsiflexion Restriction During A Rebound-Jump Task. J Funct Morphol Kinesiol 2018; 3:jfmk3040052. [PMID: 33466981 PMCID: PMC7739253 DOI: 10.3390/jfmk3040052] [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: 08/22/2018] [Revised: 10/19/2018] [Accepted: 10/23/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study compared differences between a control group and a group with unilateral ankle dorsiflexion restriction in the ground reaction force (GRF), angles of the lower limbs joints, and muscular activity during a rebound-jump task in athletes who continue to perform sports activities with unilateral ankle dorsiflexion restriction. METHODS The athletes were divided into the following two groups: The dorsiflexion group included those with a difference of ≥7° between bilateral ankle dorsiflexion angles (DF), and the control group included those with a difference of <7° between the two ankles (C). An ankle foot orthosis was attached to subjects in group C to apply a restriction on the right-angle dorsiflexion angle. The percentage of maximum voluntary contraction (%MVC) of the legs musculature, components of the GRF, and the hip and knee joint angles during the rebound-jump task were compared between groups DF and C. RESULTS Group DF showed increased %MVC of the quadriceps muscle, decreased upward component of the GRF, decreased hip flexion, and increased knee eversion angles. CONCLUSIONS This study highlighted that athletes with ankle dorsiflexion restriction had significantly larger knee eversion angles in the rebound-jump task. The reduced hip flexion was likely caused by the restricted ankle dorsiflexion and compensated by the observed increase in quadriceps muscle activation when performing the jump.
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Affiliation(s)
- Hitoshi Kondo
- Physical Therapy, Department of Rehabilitation, Fukui College of Health Sciences, 55 Egami-cho 13-1, Fukui 910-3190, Japan; ; Tel.: +81-0776-59-2200
- Physical Therapy, Department of Rehabilitation, Faculty of Health Science, Fukui Health Science University, 55 Egami-cho 13-1, Fukui 910-3190, Japan
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Balsalobre-Fernández C, Romero-Franco N, Jiménez-Reyes P. Concurrent validity and reliability of an iPhone app for the measurement of ankle dorsiflexion and inter-limb asymmetries. J Sports Sci 2018; 37:249-253. [DOI: 10.1080/02640414.2018.1494908] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Carlos Balsalobre-Fernández
- Department of Physical Education, Sport and Human Movement, Universidad Autónoma de Madrid, Madrid, Spain
- Laboratory of Exercise Physiology Research Group, Department of Health and Human Performance, School of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Natalia Romero-Franco
- Nursing and Physiotherapy Department, University of the Balearic Islands, Palma de Mallorca, Spain
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Attias M, Bonnefoy-Mazure A, De Coulon G, Cheze L, Armand S. Influence of different degrees of bilateral emulated contractures at the triceps surae on gait kinematics: The difference between gastrocnemius and soleus. Gait Posture 2017; 58:176-182. [PMID: 28797961 DOI: 10.1016/j.gaitpost.2017.07.118] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 07/21/2017] [Accepted: 07/28/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Ankle plantarflexion contracture results from a permanent shortening of the muscle-tendon complex. It often leads to gait alterations. The objective of this study was to compare the kinematic adaptations of different degrees of contractures and between isolated bilateral gastrocnemius and soleus emulated contractures using an exoskeleton. METHODS Eight combinations of contractures were emulated bilaterally on 10 asymptomatic participants using an exoskeleton that was able to emulate different degrees of contracture of gastrocnemius (biarticular muscle) and soleus (monoarticular muscle), corresponding at 0°, 10°, 20°, and 30° ankle plantarflexion contracture (knee-flexed and knee-extended). Range of motion was limited by ropes attached for soleus on heel and below the knee and for gastrocnemius on heel and above the knee. A gait analysis session was performed to evaluate the effect of these different emulated contractures on the Gait Profile Score, walking speed and gait kinematics. RESULTS Gastrocnemius and soleus contractures influence gait kinematics, with an increase of the Gait Profile Score. Significant differences were found in the kinematics of the ankles, knees and hips. Contractures of soleus cause a more important decrease in the range of motion at the ankle than the same degree of gastrocnemius contractures. Gastrocnemius contractures cause greater knee flexion (during the stance phase) and hip flexion (during all the gait cycle) than the same level of soleus contractures. CONCLUSION These results can support the interpretation of the Clinical Gait Analysis data by providing a better understanding of the effect of isolate contracture of soleus and gastrocnemius on gait kinematics.
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Affiliation(s)
- M Attias
- Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Switzerland; HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences, Geneva, Switzerland; Univ Lyon, Université Lyon 1, IFSTTAR, LBMC UMR_T9406, F69622, Lyon, France.
| | - A Bonnefoy-Mazure
- Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Switzerland
| | - G De Coulon
- Pediatric Orthopaedic Service, Department of Child and Adolescent, Geneva University Hospitals and Geneva University, Geneva, Switzerland
| | - L Cheze
- Univ Lyon, Université Lyon 1, IFSTTAR, LBMC UMR_T9406, F69622, Lyon, France
| | - S Armand
- Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Switzerland
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Lima YL, Ferreira VMLM, de Paula Lima PO, Bezerra MA, de Oliveira RR, Almeida GPL. The association of ankle dorsiflexion and dynamic knee valgus: A systematic review and meta-analysis. Phys Ther Sport 2017; 29:61-69. [PMID: 28974358 DOI: 10.1016/j.ptsp.2017.07.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 06/30/2017] [Accepted: 07/15/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The objective of this systematic review was to evaluate the association between ankle dorsiflexion (ADF) and dynamic knee valgus (DKV). METHODS Electronic searches were conducted in MEDLINE, EMBASE, CINAHL and SPORTDiscus. A modified Downs and Black checklist was used for quality assessment and meta-analysis was performed to compare standardised mean differences (SMD) of ADF. RESULTS Seventeen studies met the inclusion criteria. Meta-analysis showed that reduced ADF is associated with participants presenting with DKV compared to controls (SMD -0.65, 95% CI -0.88 to -0.41). Subgroup analysis showed consistent results regarding different forms of ADF measurement; restriction in ADF measured in weight-bearing position (SMD -1.25, 95% CI -2.24 to -0.25), non-weight-bearing with knee flexed (SMD -0.56, 95% CI -0.97 to -0.16) or non-weight-bearing with knee extended (SMD -0.54, 95% CI -0.80 to -0.28) was significantly associated with DKV. CONCLUSION The meta-analysis results provide evidence that reduced ADF is correlated with DKV. The assessment of ADF in the clinical setting is important, as it may be related to harmful movement patterns of the lower limbs.
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Affiliation(s)
- Yuri Lopes Lima
- Department of Physical Therapy, Federal University of Ceará, Fortaleza, Ceará, Brazil
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Attias M, Bonnefoy-Mazure A, De Coulon G, Cheze L, Armand S. Feasibility and reliability of using an exoskeleton to emulate muscle contractures during walking. Gait Posture 2016; 50:239-245. [PMID: 27665088 DOI: 10.1016/j.gaitpost.2016.09.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 09/16/2016] [Accepted: 09/18/2016] [Indexed: 02/02/2023]
Abstract
Contracture is a permanent shortening of the muscle-tendon-ligament complex that limits joint mobility. Contracture is involved in many diseases (cerebral palsy, stroke, etc.) and can impair walking and other activities of daily living. The purpose of this study was to quantify the reliability of an exoskeleton designed to emulate lower limb muscle contractures unilaterally and bilaterally during walking. An exoskeleton was built according to the following design criteria: adjustable to different morphologies; respect of the principal lines of muscular actions; placement of reflective markers on anatomical landmarks; and the ability to replicate the contractures of eight muscles of the lower limb unilaterally and bilaterally (psoas, rectus femoris, hamstring, hip adductors, gastrocnemius, soleus, tibialis posterior, and peroneus). Sixteen combinations of contractures were emulated on the unilateral and bilateral muscles of nine healthy participants. Two sessions of gait analysis were performed at weekly intervals to assess the reliability of the emulated contractures. Discrete variables were extracted from the kinematics to analyse the reliability. The exoskeleton did not affect normal walking when contractures were not emulated. Kinematic reliability varied from poor to excellent depending on the targeted muscle. Reliability was good for the bilateral and unilateral gastrocnemius, soleus, and tibialis posterior as well as the bilateral hamstring and unilateral hip adductors. The exoskeleton can be used to replicate contracture on healthy participants. The exoskeleton will allow us to differentiate primary and compensatory effects of muscle contractures on gait kinematics.
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Affiliation(s)
- M Attias
- Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Switzerland; HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences, Geneva, Switzerland; Univ Lyon, Université Lyon 1, IFSTTAR, LBMC UMR_T9406, F69622, Lyon, France.
| | - A Bonnefoy-Mazure
- Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Switzerland
| | - G De Coulon
- Pediatric Orthopaedic Service, Department of Child and Adolescent, Geneva University Hospitals and Geneva University, Geneva, Switzerland
| | - L Cheze
- Univ Lyon, Université Lyon 1, IFSTTAR, LBMC UMR_T9406, F69622, Lyon, France
| | - S Armand
- Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Switzerland
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Fukaya T, Mutsuzaki H, Okubo T, Mori K, Wadano Y. Relationships between the center of pressure and the movements of the ankle and knee joints during the stance phase in patients with severe medial knee osteoarthritis. Knee 2016; 23:631-6. [PMID: 27242284 DOI: 10.1016/j.knee.2016.02.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 09/23/2015] [Accepted: 02/29/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND The knee joint movement during the stance phase is affected by altered ankle movement and the center of pressure (COP). However the relationships between changes in the center of pressure (COP) and the altered kinematics and kinetics of the ankle and knee joints in patients with osteoarthritis (OA) of the knee are not well understood. The purpose of this study was to determine the relationships between changes in the COP and the altered kinematic and kinetic variables in ankle and knee joints during the stance phase in patients with medial knee OA. METHODS Fourteen patients with knee OA (21 knees) and healthy subjects were assessed by gait analysis using an eight-camera motion analysis system to record forward and lateral shifts in the COP and the angle and net internal moments of the knee and ankle joint. Spearman rank-correlation coefficients were used to determine the relationship between these results. RESULTS In knees with medial OA, lateral shifts in the COP were correlated with knee flexion angle. Lateral shifts in the COP were correlated with the second peak of the knee extensor moment and correlated with the knee abductor moment. CONCLUSIONS In patients with medial knee OA, lateral shifts in the COP were negatively correlated with the kinematic and kinetic variables in the sagittal plane of the knee joints. Controlling such lateral shifts in the COP may thus be an effective intervention for mechanical loads on the knee during the stance phase in patients with knee OA.
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Affiliation(s)
- Takashi Fukaya
- Department of Physical Therapy, Faculty of Health Sciences, Tsukuba International University, Ibaraki, Japan.
| | - Hirotaka Mutsuzaki
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Tomoyuki Okubo
- Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Koichi Mori
- Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Yasuyoshi Wadano
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
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Resende RA, Kirkwood RN, Deluzio KJ, Cabral S, Fonseca ST. Biomechanical strategies implemented to compensate for mild leg length discrepancy during gait. Gait Posture 2016; 46:147-53. [PMID: 27131193 DOI: 10.1016/j.gaitpost.2016.03.012] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 02/03/2016] [Accepted: 03/13/2016] [Indexed: 02/02/2023]
Abstract
Although mild leg length discrepancy is related to lower limb injuries, there is no consensus regarding its effects on the biomechanics of the lower limbs during gait. Biomechanical data of 19 healthy participants were collected while they walked under different conditions as described: (1) control condition-wearing flat thick sandals; (2) short limb condition-wearing a flat thick sandal on the left and a flat thin sandal on the right foot; (3) long limb condition: wearing flat thin sandal on the left and flat thick sandal on the right foot. The thick and thin sandals had 1.45cm of mean thickness difference. The right lower limb data were analyzed for all conditions. Ankle, knee, hip and pelvis kinematics and internal moments were measured with a motion capture system and six force platforms. Principal component analysis was used to compare differences between conditions. The scores of the principal components were compared between conditions using one-way repeated measures ANOVA. Twelve gait variables were different between conditions: rearfoot dorsiflexion and inversion (p<0.001); ankle dorsiflexion and inversion moments (p<0.001); knee flexion angle and moment (p<0.001); knee adduction moment (p<0.001); hip flexion angle and moment (p<0.001); hip adduction angle (p=0.001) and moment (p=0.022); and pelvic ipsilateral drop (p<0.001). Mild leg length discrepancy caused compensatory changes during gait, apparently to equalize the functional length of the lower limbs. However, these strategies did not fully succeed, since both short and long limb conditions affected pelvic motion in the frontal plane. These results suggest that mild leg length discrepancy should not be overlooked in clinical settings.
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Affiliation(s)
- Renan A Resende
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Avenida Antônio Carlos 6627 Campus Pampulha, Pampulha, 31270-901 Belo Horizonte, MG, Brazil.
| | - Renata N Kirkwood
- Wilfrid Laurier University, 75 University Avenue W, Waterloo, N2L 3C5, ON, Canada.
| | - Kevin J Deluzio
- Queen's University, McLaughlin Hall, Faculty of Engineering and Applied Science, Department of Mechanical and Materials Engineering, Kingston, ON, Canada.
| | - Silvia Cabral
- U Lisboa, Fac Motricidade Humana, CIPER, LBMF, P-1499-002, Lisboa, Portugal.
| | - Sérgio T Fonseca
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Avenida Antônio Carlos 6627 Campus Pampulha, Pampulha, 31270-901 Belo Horizonte, MG, Brazil.
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Kondo H, Someya F. Changes in ground reaction force during a rebound-jump task after hip strength training for single-sided ankle dorsiflexion restriction. J Phys Ther Sci 2016; 28:319-25. [PMID: 27065513 PMCID: PMC4792967 DOI: 10.1589/jpts.28.319] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 10/30/2015] [Indexed: 12/26/2022] Open
Abstract
[Purpose] Lateral ankle sprains are common injuries suffered while playing sports, and
abnormal forward- and inward-directed ground reaction force occurs during a jumping task.
However, the influence of hip muscle strength training on jumping performance after ankle
injuries has not been fully examined. This study thus examined changes in ground reaction
force during a rebound-jump task after training to strengthen hip muscles. [Subjects and
Methods] Ten of 30 female high school basketball players were assigned as subjects who
showed a difference of 7 or more degrees in dorsiflexion ranges between the bilateral
ankles. The subjects underwent 12 weeks of training to strengthen hip abductors and
external rotators. Comparisons between before and after training were made regarding
ground reaction force components, hip and knee joint angles, percentage of maximum
voluntary contraction in leg muscles, and muscle strength of hip muscles during the
rebound-jump task. [Results] After training, the subjects showed increased strength of
external rotator muscles, increased percentage of maximum voluntary contraction in the
gluteus medius muscle, decreased inward ground reaction force, and increased flexion
angles of the hip and knee joints. [Conclusion] This study suggests that training to
strengthen hip muscles may ameliorate the inward ground reaction force in athletes with
ankle dorsiflexion restriction.
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Affiliation(s)
- Hitoshi Kondo
- Department of Rehabilitation, Physical Therapy, Fukui College of Health Sciences, Japan; Division of Health Sciences, Kanazawa University Graduate School of Medical Science, Japan
| | - Fujiko Someya
- School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan
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Attias M, Chevalley O, Bonnefoy-Mazure A, De Coulon G, Cheze L, Armand S. Effects of contracture on gait kinematics: A systematic review. Clin Biomech (Bristol, Avon) 2016; 33:103-110. [PMID: 26970702 DOI: 10.1016/j.clinbiomech.2016.02.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 02/19/2016] [Accepted: 02/23/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Contractures of a major joint in the lower limbs may impair human walking in addition to other daily living activities. A contracture is defined as the inability of a joint to perform the full range of motion and excessive resistance during passive mobilization of the joint. Few studies have reported methods describing how to evaluate contractures. Understanding the association among all of these studies seems essential to improve patient management. Therefore, we conducted a systematic review on this topic to elucidate the influence of contractures on gait kinematics. METHODS An electronic search in the literature will be conducted. Studies were screened by title and abstract and full texts were evaluated secondarily for definitive inclusion. The quality of the included studies was assessed independently by the two review authors with the Modified Quality Assessment Checklist. The included studies were separated into three categories: pathological contracture versus healthy controls (descriptive), simulated contracture versus healthy controls (experimental), and pre- and post-kinematics after surgical muscle lengthening (surgery). FINDINGS From a total of 4402 references, 112 original articles were selected, and 28 studies were identified in this systematic review. No significant difference between raters was observed on the total score of the Modified Quality Assessment Checklist. INTERPRETATION Contractures influence walking depending on the location (muscle) and the contracture level (muscle-tendon length). After giving a definition of contracture, this review identified some contracture alterations, such as plantarflexion, knee flexion and hip flexion contractures, with a kinematic description and presented possible different compensations.
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Affiliation(s)
- Michael Attias
- Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Switzerland; HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences, Geneva, Switzerland; Université Claude Bernard Lyon 1, Villeurbanne, France.
| | | | - Alice Bonnefoy-Mazure
- Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Switzerland
| | - Geraldo De Coulon
- Pediatric Orthopaedic Service, Department of Child and Adolescent, Geneva University Hospitals and Geneva University, Geneva, Switzerland
| | | | - Stéphane Armand
- Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Switzerland
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Appasamy M, De Witt ME, Patel N, Yeh N, Bloom O, Oreste A. Treatment Strategies for Genu Recurvatum in Adult Patients With Hemiparesis: A Case Series. PM R 2014; 7:105-12. [DOI: 10.1016/j.pmrj.2014.10.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 10/03/2014] [Accepted: 10/12/2014] [Indexed: 10/24/2022]
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