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Swisser F, Brethe Y, Choquet O, Herteleer M, Bernard N, Laffont I, Bringuier S, Capdevila X. Plantar Compartment Block Improves Enhanced Recovery after Hallux Valgus Surgery: A Randomized, Comparative, Double-blind Study. Anesthesiology 2024; 141:891-903. [PMID: 39102486 DOI: 10.1097/aln.0000000000005180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
BACKGROUND Walking ability is a key factor in enhanced recovery after foot ambulatory surgery. Plantar compartment block offers an analgesic alternative to popliteal sciatic nerve block (PSNB) for hallux valgus surgery. The objective of this study was to compare these two regional anesthesia strategies on patients' ability to recover a painless unaided walk. METHODS This prospective double-blinded (patient; observing anesthesiologist) randomized study compared patients scheduled for hallux valgus surgery receiving PSNB with 1% mepivacaine, then combined plantar and peroneal nerve blocks (plantar compartment block [PCB] group) with ropivacaine 0.5% and dexamethasone, or PSNB with ropivacaine 0.5% and dexamethasone (control group). The primary outcome was the patient's ability to walk unaided 6 h after PSNB. The test was performed on a GAITRite, spatio-temporal gait analysis mat. For 3 days, the number of patient steps, pain levels, rescue analgesics, patient's experience, and adverse events were assessed. RESULTS Sixty patients were included and 59 were analyzed. The number of patients walking unaided on the GAITRite mat was significantly higher in the PCB group (21 of 30, 70%) than in the control group (4 of 29, 13.8%; P < 0.001). Gait quality using the Functional Ambulation Profile score was 63 ± 13.6 in the PCB group and 49.5 ± 4.7 in the control group (P < 0.001). Median time to free ambulation at home was significantly lower in the PCB group (9 h [8.2 to 11.8]) than in the control group (33.5 h [24 to 47]; P < 0.001). Postoperative pain did not differ between the groups (β = -0.41 [-1.78 to 0.95]; P = 0.548). The number of steps on day 3, the time of first rescue analgesic, the number of patients using rescue analgesia, consumption of morphine, and patient's experience did not differ between the groups. CONCLUSIONS PCB decreased the time to return to unaided walking, with improved gait, compared with PSNB, improving effective analgesia and low consumption of rescue analgesics. This innovative regional anesthesia strategy enhanced recovery after surgery. EDITOR’S PERSPECTIVE
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Affiliation(s)
- Fabien Swisser
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - Yann Brethe
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - Olivier Choquet
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - Matthias Herteleer
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France; Department of Anatomy, Lille University School of Medicine, Lille, France
| | - Nathalie Bernard
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - Isabelle Laffont
- Physical Medicine and Rehabilitation Department, Centre Hospitalo-Universitaire Montpellier, University of Montpellier, Montpellier, France; Euromov, UFR STAPS, University of Montpellier, Montpellier, France
| | - Sophie Bringuier
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France; Department of Medical Statistics, Montpellier University Hospital, Montpellier, France; Desbrest Institute of Epidemiology and Public Health, Univ Montpellier, INSERM, Montpellier, France
| | - Xavier Capdevila
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France; INSERM Unit 1298 Montpellier NeuroSciences Institute, Montpellier University, Montpellier, France
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Lunardelli AN, Martins DF, Lunardelli SE, Martins LGT, Salgado ASI, Viseux FJF, Schleip R, Traebert E, Traebert J. Relationship Between Dental Trauma and Orthostatic Balance in Children. Dent Traumatol 2024. [PMID: 39318175 DOI: 10.1111/edt.12995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 08/28/2024] [Accepted: 08/31/2024] [Indexed: 09/26/2024]
Abstract
BACKGROUND Dental trauma (DT) and falls have shown to be associated. On the other hand, postural balance is associated with falls and depends on the integration of the body's regulatory systems. The aim of this study was to investigate the potential relationship between DT and alteration of orthostatic balance in children. METHODS This was a population-based case-control study involving 296 six-year-old schoolchildren. The case group included children with previous history of DT. The control group included children with no previous history of DT. Stabilometric measurements were the main exposure of this study. Logistic regression analyzes were performed to estimate potential differences in terms of chance of occurrence. RESULTS The cases reviewed showed a 4.37 times chance of reduced balance in the measurement of the anteroposterior trajectory speed of the orthostatic center of pressure (COP), when children had their eyes closed. It also presented a chance of 3.06 times reduced balance in the measurement of the orthostatic center of pressure latero-lateral sway, with children with open eyes and stepping on a foam pad, and 4.00 times of reduced balance in the width of the latero-lateral sway of the orthostatic center of pressure, with children with open eyes and stepping on a foam pad. CONCLUSION Children with previous history of DT showed a higher chance of experiencing a reduced orthostatic balance in different conditions when compared to children without the occurrence of trauma.
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Affiliation(s)
- Abelardo Nunes Lunardelli
- Postgraduate Program in Health Sciences, Universidade do Sul de Santa Catarina, Palhoça, Santa Catarina, Brazil
| | - Daniel Fernandes Martins
- Postgraduate Program in Health Sciences, Universidade do Sul de Santa Catarina, Palhoça, Santa Catarina, Brazil
| | - Sandra Espíndola Lunardelli
- Postgraduate Program in Health Sciences, Universidade do Sul de Santa Catarina, Palhoça, Santa Catarina, Brazil
| | | | | | - Frederic Jean François Viseux
- Pain Assessment and Treatment Center, Centre Hospitalier de Valenciennes, Valenciennes, France
- Laboratory of Automation, Mechanics and Industrial and Human Computing, Université Polytechnique des Hauts-de-France, Valenciennes, France
| | - Robert Schleip
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
- Department for Medical Professions, University of Applied Sciences, Bad Sooden-Allendorf, Germany
| | - Eliane Traebert
- Postgraduate Program in Health Sciences, Universidade do Sul de Santa Catarina, Palhoça, Santa Catarina, Brazil
| | - Jefferson Traebert
- Postgraduate Program in Health Sciences, Universidade do Sul de Santa Catarina, Palhoça, Santa Catarina, Brazil
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da Silva Costa AA, Moraes R, den Otter R, Gennaro F, Bakker L, Rocha Dos Santos PC, Hortobágyi T. Corticomuscular and intermuscular coherence as a function of age and walking balance difficulty. Neurobiol Aging 2024; 141:85-101. [PMID: 38850592 DOI: 10.1016/j.neurobiolaging.2024.05.004] [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: 09/25/2023] [Revised: 04/12/2024] [Accepted: 05/08/2024] [Indexed: 06/10/2024]
Abstract
We determined beta-band intermuscular (IMC) and corticomuscular coherence (CMC) as a function of age and walking balance difficulty. Younger (n=14, 23y) and older individuals (n=19, 71y) walked 13 m overground, on a 6-cm-wide ribbon overground, and on a 6-cm-wide (5-cm-high) beam. Walking distance as a proxy for walking balance and speed were computed. CMC was estimated between electroencephalographic signal at Cz electrode and surface electromyographic signals of seven leg muscles, while IMC was calculated in four pairs of leg muscles, during stance and swing gait phases. With increasing difficulty, walking balance decreased in old individuals and speed decreased gradually independent of age. Beam walking increased IMC, while age increased IMC in proximal muscle pairs, and decreased IMC in distal muscle pairs. Age and difficulty increased CMC independent of gait phases. Concluding, CMC and IMC increased with walking balance difficulty and age, except for distal muscle pairs, which had lower IMC with age. These findings suggest an age-related increase in corticospinal involvement in the neural control of walking balance. DATA AVAILABILITY: The datasets used in this study are available from the corresponding author upon reasonable request.
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Affiliation(s)
- Andréia Abud da Silva Costa
- Ribeirão Preto Medical School, Graduate Program in Rehabilitation and Functional Performance, University of São Paulo, Brazil; Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil; Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands.
| | - Renato Moraes
- Ribeirão Preto Medical School, Graduate Program in Rehabilitation and Functional Performance, University of São Paulo, Brazil; Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
| | - Rob den Otter
- Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands
| | - Federico Gennaro
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Lisanne Bakker
- Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands
| | - Paulo Cezar Rocha Dos Santos
- Department of Computer Science & Applied Mathematics, Weizmann Institute of Science, Israel; The Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Israel; IDOR/Pioneer Science Initiative, Rio de Janeiro, RJ, Brazil
| | - Tibor Hortobágyi
- Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands; Department of Kinesiology, Hungarian University of Sports Science, Budapest 1123, Hungary; Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary
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Tsiouri C, Amiridis IG, Kannas T, Varvariotis N, Sahinis C, Hatzitaki V, Enoka RM. EMG coherence of foot and ankle muscles increases with a postural challenge in men. Gait Posture 2024; 113:238-245. [PMID: 38959555 DOI: 10.1016/j.gaitpost.2024.06.019] [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: 02/02/2024] [Revised: 06/07/2024] [Accepted: 06/19/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND The functional role of intrinsic foot muscles in the control of standing balance is often overlooked in rehabilitation, partly because the interactions with ankle muscles are poorly understood. RESEARCH QUESTION How does coactivation of Flexor Digitorum Brevis (FDB) and soleus (SOL) vary across standing tasks of increasing difficulty. METHODS Postural sway (Centre of Pressure, CoP) and the electromyographic (EMG) activity of FDB, SOL, Medial Gastrocnemius (MG) and Tibialis Anterior (TA) were measured during bipedal standing, tandem stance, one-legged balance, and standing on toes. Coherence of the rectified EMG signals for SOL and FDB in two bandwidths (0-5 and 10-20 Hz) was calculated as a coactivation index. RESULTS AND SIGNIFICANCE The CoP sway and the EMG activity of all muscles was greater (P<0.05) for the three difficult tasks. Significant coherence between the SOL and FDB EMG activity was found in both frequency regions: 0-5 and 10-20 Hz. The coherence integral increased with the difficulty of the postural task, especially in the 10-20 Hz band. The findings underscore the important role of FDB in the control of standing balance across tasks and its coactivation with SOL. Clinical recommendations to improve balance control need to consider the interaction between the plantar flexor and intrinsic-foot muscles.
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Affiliation(s)
- Chrysi Tsiouri
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Ioannis G Amiridis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece.
| | - Theodoros Kannas
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Nikolaos Varvariotis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Chrysostomos Sahinis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Vassilia Hatzitaki
- Laboratory of Motor Control, Department of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, Greece
| | - Roger M Enoka
- Neurophysiology of Movement Laboratory, Department of Integrative Physiology, University of Colorado, Boulder, CO, USA
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Zając B, Olszewski M, Mika A. Influence of protocol variables on outcomes of the star excursion balance test group (SEBT, mSEBT, YBT-LQ) in healthy individuals: a systematic review. Front Physiol 2024; 15:1415887. [PMID: 39156827 PMCID: PMC11327093 DOI: 10.3389/fphys.2024.1415887] [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: 04/11/2024] [Accepted: 06/26/2024] [Indexed: 08/20/2024] Open
Abstract
Background The "SEBT group," which includes the Star Excursion Balance Test (SEBT), its modified version (mSEBT), and the Lower Quarter Y-Balance Test (YBT-LQ), is used to assess the limits of stability. Interestingly, the testing protocol allows users a considerable degree of flexibility, which can affect the obtained results. Therefore, the objective of this systematic review was to analyze the impact of different protocol variants within the "SEBT group" on outcomes. Methods Data were acquired by searching 4 databases (MEDLINE, ScienceDirect, Wiley, Springer Link) focusing on studies published in English in peer-reviewed journals, empirical in nature, conducted on healthy individuals, and examining the effects of various protocol variants on test outcomes. Study quality was assessed with the NHLBI quality assessment tool for pre-post studies with no control group. Results The calculation method based on the maximum repetition yields statistically significantly higher results compared to other calculation methods. Allowing unrestricted arm movements during the test results in statistically significantly higher scores compared to the procedure that restricts arm movements. The impact of a warm-up, wearing footwear during testing, and using a dedicated kit remains ambiguous. To obtain reliable results, 4-6 familiarization trials are necessary, though fewer may suffice for athletes experienced in performing the test. Conclusion This systematic review highlights the significant impact of the calculation method and arm movement restrictions on the outcomes of the "SEBT group." The effects of wearing footwear during testing, warm-up, and using a dedicated test kit remain unclear. The required number of familiarization repetitions may varies depending on biological maturity level of the person being tested. Future research should develop a warm-up protocol tailored to the needs of the "SEBT group," and investigate the impact of heel elevation during testing on outcomes. Systematic review registration The protocol for this systematic review was prospectively registered in the OSF Registries (https://doi.org/10.17605/OSF.IO/JSKH2).
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Affiliation(s)
- Bartosz Zając
- Laboratory of Functional Diagnostics, Central Scientific and Research Laboratory, University of Physical Education in Kraków, Kraków, Poland
| | - Maciej Olszewski
- Doctoral School, University of Physical Education in Kraków, Kraków, Poland
| | - Anna Mika
- Institute of Clinical Rehabilitation, University of Physical Education in Kraków, Kraków, Poland
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Nanivadekar AC, Bose R, Petersen BA, Okorokova EV, Sarma D, Madonna TJ, Barra B, Farooqui J, Dalrymple AN, Levy I, Helm ER, Miele VJ, Boninger ML, Capogrosso M, Bensmaia SJ, Weber DJ, Fisher LE. Restoration of sensory feedback from the foot and reduction of phantom limb pain via closed-loop spinal cord stimulation. Nat Biomed Eng 2024; 8:992-1003. [PMID: 38097809 PMCID: PMC11404213 DOI: 10.1038/s41551-023-01153-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/27/2023] [Indexed: 12/30/2023]
Abstract
Restoring somatosensory feedback in individuals with lower-limb amputations would reduce the risk of falls and alleviate phantom limb pain. Here we show, in three individuals with transtibial amputation (one traumatic and two owing to diabetic peripheral neuropathy), that sensations from the missing foot, with control over their location and intensity, can be evoked via lateral lumbosacral spinal cord stimulation with commercially available electrodes and by modulating the intensity of stimulation in real time on the basis of signals from a wireless pressure-sensitive shoe insole. The restored somatosensation via closed-loop stimulation improved balance control (with a 19-point improvement in the composite score of the Sensory Organization Test in one individual) and gait stability (with a 5-point improvement in the Functional Gait Assessment in one individual). And over the implantation period of the stimulation leads, the three individuals experienced a clinically meaningful decrease in phantom limb pain (with an average reduction of nearly 70% on a visual analogue scale). Our findings support the further clinical assessment of lower-limb neuroprostheses providing somatosensory feedback.
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Affiliation(s)
- Ameya C Nanivadekar
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
| | - Rohit Bose
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
| | - Bailey A Petersen
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
| | - Elizaveta V Okorokova
- Department of Organismal Biology and Anatomy, University of Chicago, Chicago, IL, USA
| | - Devapratim Sarma
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Tyler J Madonna
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Beatrice Barra
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neuroscience and Movement Science, University of Fribourg, Fribourg, Switzerland
| | - Juhi Farooqui
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
| | - Ashley N Dalrymple
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
- Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT, USA
| | - Isaiah Levy
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eric R Helm
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Vincent J Miele
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael L Boninger
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marco Capogrosso
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sliman J Bensmaia
- Department of Organismal Biology and Anatomy, University of Chicago, Chicago, IL, USA
| | - Douglas J Weber
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Lee E Fisher
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA.
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.
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Soares D, Fletcher I, Mitchell A, Charalambous L. Identifying the Number of Steps Required for Familiarisation to Athletic Footwear in Healthy Older Adults. Gerontology 2024:1-8. [PMID: 39047716 DOI: 10.1159/000540022] [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: 03/15/2024] [Accepted: 06/22/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION Research on athletic footwear familiarisation within an older population is sparse. This is problematic because unfamiliar footwear may act as a new perturbation and modify older adults' walking gait and stability. In addition, while athletic footwear has been suggested to enhance older adults' comfort and support during activities of daily living, the necessary period for familiarisation with athletic footwear is unknown. Therefore, this study aimed to identify the number of steps required for older adults to be familiarised with athletic footwear of different midsole thicknesses. METHODS Twenty-six healthy and physically active community-dwelling older adults, 21 females (71.1 ± 4.5 years; 164.5 ± 5.3 cm; 68.4 ± 11.4 kg) and five males (70.6 ± 2.3 years; 175.2 ± 7.8 cm; 72.8 ± 9.7 kg), completed a walking-based protocol. Participants walked two trials of 200 steps at their habitual speed on a 10-m track of an optical measurement system in three footwear conditions: (1) New Balance® REVlite 890v6 (thick midsole); (2) New Balance® REVlite 1400v5 (moderate midsole); and (3) New Balance® Minimus 20v7 (thin midsole). Gait speed (m.s-1) and walking time (min) were analysed for each participant over the 400 steps. Number of required familiarisation steps were established over three analysis phases, consisting of steady-state gait assessment, averaging and analysis of blocks of 40 steps, and sequentially comparing these steps with a predetermined threshold. Footwear familiarisation was assumed when the mean gait speed fell within an acceptable level (±2 SD from 320 to 360 step values) and subsequently maintained. RESULTS Most participants were familiarised with all three footwear conditions (thick n = 18; moderate and thin n = 20) after walking 80 steps. For all participants, the moderate midsole had the shortest familiarisation period (160 steps). The highest number of familiarisation steps was found in the thick (320 steps) and thin midsoles (240 steps) for some participants. CONCLUSION A minimum of 320 familiarisation steps is recommended to account for both individual differences and midsole thicknesses. Implementing this walking-based footwear familiarisation protocol would improve validity of future studies, ensuring they analyse footwear effects rather than familiarisation with the footwear.
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Affiliation(s)
- Diana Soares
- Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, UK,
| | - Iain Fletcher
- Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, UK
| | - Andrew Mitchell
- Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, UK
| | - Laura Charalambous
- Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, UK
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Raitor M, Ruggles SW, Delp SL, Liu CK, Collins SH. Lower-Limb Exoskeletons Appeal to Both Clinicians and Older Adults, Especially for Fall Prevention and Joint Pain Reduction. IEEE Trans Neural Syst Rehabil Eng 2024; 32:1577-1585. [PMID: 38536680 DOI: 10.1109/tnsre.2024.3381979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Exoskeletons are a burgeoning technology with many possible applications to improve human life; focusing the effort of exoskeleton research and development on the most important features is essential for facilitating adoption and maximizing positive societal impact. To identify important focus areas for exoskeleton research and development, we conducted a survey with 154 potential users (older adults) and another survey with 152 clinicians. The surveys were conducted online and to ensure a consistent concept of an exoskeleton across respondents, an image of a hip exoskeleton was shown during exoskeleton-related prompts. The survey responses indicate that both older adults and clinicians are open to using exoskeletons, fall prevention and joint pain reduction are especially important features, and users are likely to wear an exoskeleton in the scenarios when it has the greatest opportunity to help prevent a fall. These findings can help inform future exoskeleton research and guide the development of devices that are accepted, used, and provide meaningful benefit to users.
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Yamashita T, Yamashita K, Sato M, Ata S. Improvement of postural control in the frail older adults through foot care: A pre- and post-intervention study. Med Eng Phys 2024; 125:104115. [PMID: 38508791 DOI: 10.1016/j.medengphy.2024.104115] [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: 11/04/2022] [Revised: 12/28/2023] [Accepted: 02/13/2024] [Indexed: 03/22/2024]
Abstract
Frailty in older adults often leads to foot issues, increasing fall-related fracture risk. Mechanoreceptors, the pressure receptors in the foot sole, are pivotal for postural control. Foot problems can impair mechanoreceptor function, compromising balance. This study aimed to examine the effect of foot care on postural control in frail older adults. Forty-eight participants underwent a five-month monthly foot care intervention. Measurements were taken before and after this intervention. Participants stood for 45 s in a static, open-eyed position on a stabilometer. Center-of-pressure (CoP) analysis included total trajectory length, integrated triangle area, rectangular area, and range of motion in anterior-posterior and medio-lateral directions. Results indicated that foot care significantly increased toe ground contact area by 1.3 times and improved anterior-posterior motion control during static standing. Enhanced postural control resulted from improved skin condition due to foot care that intensified mechanoreceptor signal input and improved postural control output. These findings underscore the potential for reducing fracture risks in older adults through proactive foot care. The study highlights the vital role of foot care in enhancing postural control, with broader implications for aging population well-being and safety.
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Affiliation(s)
- Tomoko Yamashita
- Department of Clinical Engineering, Faculty of Human Care at Makuhari, Tohto University, 1-1 Hibino, Mihama-ku, Chiba-shi, Chiba 261-0021, Japan; Graduate School of Informatics, Osaka Metropolitan University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka 558-8585, Japan.
| | - Kazuhiko Yamashita
- Department of Clinical Engineering, Faculty of Human Care at Makuhari, Tohto University, 1-1 Hibino, Mihama-ku, Chiba-shi, Chiba 261-0021, Japan
| | - Mitsuru Sato
- Department of Physical Therapy, Faculty of Rehabilitation, Gunma Paz University, 1-7-1 Tonya-machi, Takasaki, Gunma 370-0006, Japan
| | - Shingo Ata
- Graduate School of Informatics, Osaka Metropolitan University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka 558-8585, Japan
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Herteleer M, Choquet O, Swisser F, Bernard N, Gasc A, Canovas F, Dagneaux L, Bringuier S, Capdevila X. Plantar compartment block for hallux valgus surgery: a proof-of-concept anatomic and clinical study. Reg Anesth Pain Med 2024:rapm-2023-105246. [PMID: 38373818 DOI: 10.1136/rapm-2023-105246] [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: 12/22/2023] [Accepted: 02/08/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Hallux valgus surgery is associated with moderate to severe postoperative pain. We hypothesized that a plantar compartment block may be a good technique for postoperative analgesia. We describe an anatomic approach to ultrasound-guided plantar compartment block and assess the clinical efficacy of the block for outpatient surgery. METHODS The anatomic study was aimed to describe the plantar compartment, using both dissection methods and imaging, and to define a volume of local anesthetic. Patients scheduled for hallux valgus surgery with a popliteal sciatic nerve block, and combined plantar compartment and peroneal blocks were included in the clinical study. Data on attaining the criteria for rapid exit from the outpatient center, duration of sensory and analgesic block, visual analog scale (VAS) values for postoperative pain at rest and during movement, and the consumption of morphine as rescue analgesia were recorded. RESULTS Plane-by-plane dissections and cross-sections were done in five cadaveric lower limbs. The medial calcaneal nerve divides into medial plantar and lateral plantar nerves in the upper part of the plantar compartment. These nerves were surrounded by 5 mL of colored gelatin, and 10 mL of injectates dye spread to the medial calcaneal branches. Thirty patients (26 women) were included in the clinical study. There were no failures of surgical block. Ninety per cent of patients successfully passed functional testing for ambulatory exit from the center within 5 hours (25th-75th centiles, 3.8-5.5 hours). The median duration of plantar compartment sensory block was 17.3 hours (10.5-21.5 hours), and the first request for rescue analgesic was 11.75 hours (10.5-23 hours) after surgery. The median VAS score for maximum pain reported within the 48-hour period was 2 (1-6). Twelve patients received 2.5 mg (0-5 mg) of morphine on day 1. Patients were highly satisfied and no adverse events were noted. CONCLUSIONS This anatomic description of the ultrasound-guided plantar compartment block reported the injection area to target the medial and lateral plantar nerves with 5 mL of local anesthetic. Normal walking without assistance is attained rapidly with this regional anesthesia technique, and the time to request postoperative analgesia after hallux valgus surgery is long. TRIAL REGISTRATION NUMBER NCT03815422.
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Affiliation(s)
- Matthias Herteleer
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
- Department of Anatomy, Lille University School of Medicine, Lille, France
| | - Olivier Choquet
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - Fabien Swisser
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - Nathalie Bernard
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - Audrey Gasc
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - François Canovas
- Department of Orthopedic Surgery and Traumatology, Lapeyronie University Hospital, Montpellier, France
- Department of Anatomy, Montpellier University School of Medicine, Montpellier, France
| | - Louis Dagneaux
- Department of Orthopedic Surgery and Traumatology, Lapeyronie University Hospital, Montpellier, France
- Department of Anatomy, Montpellier University School of Medicine, Montpellier, France
| | - Sophie Bringuier
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
- Department of Medical Statistics, Montpellier University Hospital, 34295 Montpellier Cedex 5, France and UMR UA11INSERM-UMIDESP, Montpellier University, Montpellier, France, France
| | - Xavier Capdevila
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
- Inserm Unit 1298 Montpellier NeuroSciences Institute, Montpellier University, 34295 Montpellier Cedex 5, France
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Bonardet N, Bardel B, Lefaucheur JP, Sorel M, Créange A. Impact of textured surfaces on the orthostatic balance of patients with multiple sclerosis. Neurophysiol Clin 2024; 54:102941. [PMID: 38382135 DOI: 10.1016/j.neucli.2023.102941] [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: 01/16/2023] [Revised: 12/21/2023] [Accepted: 12/21/2023] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE To perform posturographic measurements with eyes open or closed using floor coverings with different textured surfaces to study postural control in patients with multiple sclerosis (MS). METHODS Static posturographic recordings were performed with eyes open and eyes closed on a forceplate with no covering (control condition) or covered by a textured mat with small pimples (height 2 mm) or large pimples (height 7 mm). Several posturographic variables were measured, focusing on displacements of the center of pressure (CoP) including the average velocity (Vav), the total length (L) of all displacements, and the surface (S) of the confidence ellipse. The recordings made with the textured mats were compared to the control condition with eyes open or closed. Then, the differences between the recordings made with large vs. small pimples on the one hand, and with eyes closed vs. open were calculated to assess the impact of pimple height or eye closure on posturographic measurements. Clinical assessment was based on the Expanded Disability Status Scale (EDSS) and its functional system (FS) subscores, the Modified Fatigue Impact Scale (MFIS), the Unipodal Stance test (UST), and the Timed Up-and-Go test (TUG). RESULTS Forty-six MS patients (mean EDSS score: 3.6) completed the study. Several posturographic variables, including Vav and L, deteriorated when measured on a textured mat, especially with large pimples and in eyes open condition. In contrast, no difference was found with small pimples and eyes closed, as compared to the control condition (no covering). The deleterious impact of pimple height on posturography correlated positively with the alteration of balance and gait clinically assessed by the UST and the TUG, and also with the MFIS physical and cerebral EDSS-FS subscores, and negatively with the cerebellar and brainstem subscores. On the other hand, the impact of eye closure on posturography was negatively correlated with the visual EDSS-FS subscore. DISCUSSION Static posturographic measurements made with different textured surfaces and visual conditions can be considered as a sensitive tool to measure "proprioceptive reserves". Actually, when cerebellar, brainstem, or visual functions are impaired, the resources of the sensory (proprioceptive) system, if preserved, can be recruited at a higher level and compensate for dysfunctions of other postural controls to maintain a satisfactory balance. In addition, this procedure of static posturographic examination can provide objective measurements correlated with clinical testing of balance and gait and could usefully complement EDSS scoring to assess disability affecting postural control and the risk of falling in MS patients.
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Affiliation(s)
- Nathalie Bonardet
- EA 4391, ENT, Faculté de Santé, Université Paris-Est Créteil, Créteil, France; Centre d'Evaluation et Traitement de la Douleur, Centre Hospitalier du Sud Seine-et-Marne, Nemours, France.
| | - Benjamin Bardel
- EA 4391, ENT, Faculté de Santé, Université Paris-Est Créteil, Créteil, France; Unité de Neurophysiologie Clinique, Hôpital Universitaire Henri Mondor, AP-HP, Créteil, France
| | - Jean-Pascal Lefaucheur
- EA 4391, ENT, Faculté de Santé, Université Paris-Est Créteil, Créteil, France; Unité de Neurophysiologie Clinique, Hôpital Universitaire Henri Mondor, AP-HP, Créteil, France
| | - Marc Sorel
- EA 4391, ENT, Faculté de Santé, Université Paris-Est Créteil, Créteil, France; Centre d'Evaluation et Traitement de la Douleur, Centre Hospitalier du Sud Seine-et-Marne, Nemours, France
| | - Alain Créange
- EA 4391, ENT, Faculté de Santé, Université Paris-Est Créteil, Créteil, France; Service de Neurologie, Hôpital Universitaire Henri Mondor, AP-HP, Créteil, France
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12
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Heß T, Themann P, Oehlwein C, Milani TL. Does Impaired Plantar Cutaneous Vibration Perception Contribute to Axial Motor Symptoms in Parkinson's Disease? Effects of Medication and Subthalamic Nucleus Deep Brain Stimulation. Brain Sci 2023; 13:1681. [PMID: 38137129 PMCID: PMC10742284 DOI: 10.3390/brainsci13121681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 11/28/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE To investigate whether impaired plantar cutaneous vibration perception contributes to axial motor symptoms in Parkinson's disease (PD) and whether anti-parkinsonian medication and subthalamic nucleus deep brain stimulation (STN-DBS) show different effects. METHODS Three groups were evaluated: PD patients in the medication "on" state (PD-MED), PD patients in the medication "on" state and additionally "on" STN-DBS (PD-MED-DBS), as well as healthy subjects (HS) as reference. Motor performance was analyzed using a pressure distribution platform. Plantar cutaneous vibration perception thresholds (VPT) were investigated using a customized vibration exciter at 30 Hz. RESULTS Motor performance of PD-MED and PD-MED-DBS was characterized by greater postural sway, smaller limits of stability ranges, and slower gait due to shorter strides, fewer steps per minute, and broader stride widths compared to HS. Comparing patient groups, PD-MED-DBS showed better overall motor performance than PD-MED, particularly for the functional limits of stability and gait. VPTs were significantly higher for PD-MED compared to those of HS, which suggests impaired plantar cutaneous vibration perception in PD. However, PD-MED-DBS showed less impaired cutaneous vibration perception than PD-MED. CONCLUSIONS PD patients suffer from poor motor performance compared to healthy subjects. Anti-parkinsonian medication in tandem with STN-DBS seems to be superior for normalizing axial motor symptoms compared to medication alone. Plantar cutaneous vibration perception is impaired in PD patients, whereas anti-parkinsonian medication together with STN-DBS is superior for normalizing tactile cutaneous perception compared to medication alone. Consequently, based on our results and the findings of the literature, impaired plantar cutaneous vibration perception might contribute to axial motor symptoms in PD.
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Affiliation(s)
- Tobias Heß
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
| | - Peter Themann
- Department of Neurology and Parkinson, Clinic at Tharandter Forest, 09633 Halsbruecke, Germany
| | - Christian Oehlwein
- Neurological Outpatient Clinic for Parkinson Disease and Deep Brain Stimulation, 07551 Gera, Germany
| | - Thomas L. Milani
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
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13
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Cardoso J, Rogean de Jesus Alves de Baptista C, Parra Buzzetti B, Dallemole Sartor C, Marques Júnior W, de Camargo Neves Sacco I, Mattiello-Sverzut AC. Vibration perception among children and adolescents with Charcot-Marie-tooth disease and implications for foot posture. Clin Biomech (Bristol, Avon) 2023; 110:106114. [PMID: 37804594 DOI: 10.1016/j.clinbiomech.2023.106114] [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: 12/13/2022] [Revised: 09/08/2023] [Accepted: 09/26/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Alterations in vibration perception among children and adolescents with Charcot-Marie-Tooth disease might explain observed changes in foot posture. Therefore, this cross-sectional study compared the vibration perception of the lower limbs in youths with and without Charcot-Marie-Tooth disease and verified the cut-off value of the distal vibration perception for the Charcot-Marie-Tooth group. In addition, associations between dynamic plantar pressure, vibration perception and isometric muscle strength were investigated. METHODS Participants aged 9-18 (Charcot-Marie-Tooth group n = 32; Typical group n = 32) had vibration perception measured by a 128-Hz graduated tuning fork. The static and dynamic foot posture were evaluated by the Foot Posture Index and pressure distribution measuring system, respectively. For the Charcot-Marie-Tooth group, a hand-held dynamometer evaluated the isometric muscle strength of the lower limbs. FINDINGS Children with Charcot-Marie-Tooth disease presented impaired vibration perception at the distal phalanx of the hallux and head of the first metatarsal compared to their typically developing peers, while adolescents with Charcot-Marie-Tooth disease showed impairment in all the tested regions compared to their typically developing peers. The cut-off value for vibration perception for participants with Charcot-Marie-Tooth disease was 5.7, considering the original grade of the tuning-fork 128 Hz. Among the associations established for the Charcot-Marie-Tooth group, a greater vibration perception at the distal phalanx of the hallux was associated with a longer rearfoot contact time (β = 31.02, p = 0.04). INTERPRETATION These new findings may guide the clinical evaluation and rehabilitation treatment for children and adolescents with Charcot-Marie-Tooth disease.
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Affiliation(s)
- Juliana Cardoso
- Health Science Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Beatriz Parra Buzzetti
- Health Science Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Cristina Dallemole Sartor
- Physical Therapy, Speech, and Occupational Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Wilson Marques Júnior
- Neuroscience and Behavioral Sciences Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Isabel de Camargo Neves Sacco
- Physical Therapy, Speech, and Occupational Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil
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14
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Bonardet N, Chapus J, Lefaucheur JP, Lampire N, Créange A, Sorel M. Impact of five floor coverings on the orthostatic balance of healthy subjects. Exp Brain Res 2023; 241:2499-2508. [PMID: 37661240 DOI: 10.1007/s00221-023-06698-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 08/26/2023] [Indexed: 09/05/2023]
Abstract
Plantar skin sensitivity contributes to the regulation of postural control and, therefore, changing the characteristics of the plantar support surface can modify this control. This study aimed at assessing the impact of five different floor coverings on the orthostatic balance in 48 healthy subjects. Static posturography was performed with eyes open or closed on a platform in a control condition (no covering) and with five different covering surfaces: foam, silicone, ethyl vinyl acetate, and two textured mats with small (height 2 mm) or large pimples (7 mm). The average velocity of center of pressure (CoP) displacement was the primary endpoint measure and ten other posturographic variables were assessed. Comfort and pain produced by the covering were also scored. In eyes open condition, the average velocity of CoP displacement was increased when subjects stood on the foam mat, the silicone mat, and especially the textured mat with large pimples. Several other posturographic variables showed significant changes with different types of floor coverings with eyes open. These changes were not correlated to the comfort or pain scores associated with the different surfaces. In contrast, no difference was observed compared to the control condition (no covering) with eyes closed. This study shows that adding smooth or textured floor covering can alter balance in eyes open condition. In eyes closed condition, although more disturbing for balance, healthy subjects achieved better postural adaptation, probably by mobilizing more of their proprioceptive resources. This posturographic examination procedure could, therefore, be used to assess "proprioceptive reserve" capacities in clinical practice.
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Affiliation(s)
- Nathalie Bonardet
- Faculté de Santé, EA 4391, ENT, Université Paris-Est Créteil, Créteil, France.
- Centre d'Evaluation et Traitement de la Douleur, Centre Hospitalier du Sud Seine-et-Marne, 15, rue des Chaudins, 77796, Nemours Cedex, France.
| | - Jean Chapus
- Centre de Rééducation LADAPT, Amilly, France
| | - Jean-Pascal Lefaucheur
- Faculté de Santé, EA 4391, ENT, Université Paris-Est Créteil, Créteil, France
- Unité de Neurophysiologie Clinique, Hôpital Universitaire Henri Mondor, AP-HP, Créteil, France
| | | | - Alain Créange
- Faculté de Santé, EA 4391, ENT, Université Paris-Est Créteil, Créteil, France
- Service de Neurologie, Hôpital Universitaire Henri Mondor, AP-HP, Créteil, France
| | - Marc Sorel
- Faculté de Santé, EA 4391, ENT, Université Paris-Est Créteil, Créteil, France
- Centre d'Evaluation et Traitement de la Douleur, Centre Hospitalier du Sud Seine-et-Marne, 15, rue des Chaudins, 77796, Nemours Cedex, France
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15
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Yalfani A, Ahmadi M, Asgarpoor A, Haji Ahmadi A. Effect of foot orthoses on dynamic balance in taekwondo athletes with flexible flatfoot: A randomized controlled trial. Foot (Edinb) 2023; 56:102042. [PMID: 37354702 DOI: 10.1016/j.foot.2023.102042] [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: 03/20/2023] [Revised: 04/19/2023] [Accepted: 05/06/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Flexible flatfoot (FFF) cause biomechanical and sensorimotor disorders of the foot and ankle complex and reduce of postural stability. Postural stability is an important movement skill that affects the performance of taekwondo (TKD) athletes and can lead to fall injuries. The purpose of this study is the effect 12-week application of foot orthosis (FOs) on dynamic balance in TKD athletes with FFF. METHOD In this trial, 30 girls of the TKD athletes with FFF were recruited. They were randomly assigned to experimental and control groups (15 subjects in each group). The experimental group used FOs with medial longitudinal arch support for 12 weeks, and the control group did not have any intervention. The outcome measures include navicular drop and balance in three directions: anterior-posterior, medial-lateral and overall stability. Covariance analysis was used to compare the results between two groups. RESULTS The covariance results showed that the experimental group compared to the control group with a high effect size had a significant difference in reducing of navicular drop (P = 0.000, ηp2 =0.512), anterior-posterior sway (P = 0.000, (ηp2 =0.397) medial-lateral sway (P = 0.019, ηp2 = 0.186) and overall stability sway (P = 0.008, ηp2 = 0.232). CONCLUSIONS The FOs with medial longitudinal arch support leads to FFF correction and provides mechanical stability of the foot and ankle complex. Also, the impulses sent from plantar receptors are increased and a better understanding of postural sway is transmitted to the central nervous system and balance strategies are improved.
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Affiliation(s)
- Ali Yalfani
- Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Bu-ali Sina University, Hamedan, Iran.
| | - Mohamadreza Ahmadi
- Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Bu-ali Sina University, Hamedan, Iran.
| | - Azadeh Asgarpoor
- Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Bu-ali Sina University, Hamedan, Iran.
| | - Aylar Haji Ahmadi
- Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Bu-ali Sina University, Hamedan, Iran
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16
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Machado MS, Machado ÁS, Guadagnin EC, Schmidt D, Germano AMC, Carpes FP. Short-term foot warming impacts foot sensitivity and body sway differently in older adults. Gait Posture 2023; 102:132-138. [PMID: 37015154 DOI: 10.1016/j.gaitpost.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/23/2022] [Accepted: 03/22/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Aging is accompanied by loss of foot skin sensitivity and reduced postural control. Increasing foot temperature can improve both skin sensitivity and postural control in adults. However, it remains unclear whether similar effects can be observed in older adults. RESEARCH QUESTION Can foot warming improve postural control in older adults, similar to observations in younger adults? METHODS Two foot warming protocols were conducted in 18 older adults (14 women, 4 men) to increase foot temperature by using infrared radiation to (1) warm the plantar aspect and (2) the skin of the entire foot and ankle area. We assessed the foot skin sensitivity before and after warming, considering tactile stimulation and center of pressure (CoP) displacement during 30-s standing with eyes open and closed. RESULTS AND SIGNIFICANCE Both foot warming protocols led to similar increases in skin temperature (∼6 °C) compared to the basal condition, but only warming the entire foot and ankle area increased foot sensitivity for the different regions assessed. No main effects or interactions were found for CoP variables in response to the two warming protocols. The short-term effects identified after warming the entire foot and ankle region suggest that this might be a strategy to improve skin sensitivity in older adults as observed in younger adults, but this was not the case for CoP. Future research should clarify whether the magnitude and long-lasting effects of warming could be determinant of CoP results.
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Affiliation(s)
- Mathias S Machado
- Applied Neuromechanics Research Group, Federal University of Pampa, Uruguaiana, RS, Brazil
| | - Álvaro S Machado
- Applied Neuromechanics Research Group, Federal University of Pampa, Uruguaiana, RS, Brazil
| | - Eliane C Guadagnin
- Applied Neuromechanics Research Group, Federal University of Pampa, Uruguaiana, RS, Brazil
| | - Daniel Schmidt
- Motor Control, Cognition and Neurophysiology, Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Andresa M C Germano
- Motor Control, Cognition and Neurophysiology, Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Felipe P Carpes
- Applied Neuromechanics Research Group, Federal University of Pampa, Uruguaiana, RS, Brazil.
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Jafari H, Gustafsson T. Optimal controllers resembling postural sway during upright stance. PLoS One 2023; 18:e0285098. [PMID: 37130115 PMCID: PMC10153747 DOI: 10.1371/journal.pone.0285098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/14/2023] [Indexed: 05/03/2023] Open
Abstract
The human postural control system can maintain our balance in an upright stance. A simplified control model that can mimic the mechanisms of this complex system and adapt to the changes due to aging and injuries is a significant problem that can be used in clinical applications. While the Intermittent Proportional Derivative (IPD) is commonly used as a postural sway model in the upright stance, it does not consider the predictability and adaptability behavior of the human postural control system and the physical limitations of the human musculoskeletal system. In this article, we studied the methods based on optimization algorithms that can mimic the performance of the postural sway controller in the upright stance. First, we compared three optimal methods (Model Predictive Control (MPC), COP-Based Controller (COP-BC) and Momentum-Based Controller (MBC)) in simulation by considering a feedback structure of the dynamic of the skeletal body as a double link inverted pendulum while taking into account sensory noise and neurological time delay. Second, we evaluated the validity of these methods by the postural sway data of ten subjects in quiet stance trials. The results revealed that the optimal methods could mimic the postural sway with higher accuracy and less energy consumption in the joints compared to the IPD method. Among optimal approaches, COP-BC and MPC show promising results to mimic the human postural sway. The choice of controller weights and parameters is a trade-off between the consumption of energy in the joints and the prediction accuracy. Therefore, the capability and (dis)advantage of each method reviewed in this article can navigate the usage of each controller in different applications of postural sway, from clinical assessments to robotic applications.
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Affiliation(s)
- Hedyeh Jafari
- Control Engineering Group, Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Luleå, Sweden
| | - Thomas Gustafsson
- Control Engineering Group, Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Luleå, Sweden
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Ruiz-Sánchez FJ, Martins MDR, Losa-Iglesias ME, Becerro-de-Bengoa-Vallejo R, Gómez-Salgado J, Romero-Morales C, Jiménez-Cebrián AM, López-López D. Impact of Multiple Sclerosis on Foot Health and Quality of Life: A Prospective Case-Control Investigation. Int J Public Health 2023; 68:1605593. [PMID: 36874219 PMCID: PMC9974658 DOI: 10.3389/ijph.2023.1605593] [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: 11/15/2022] [Accepted: 02/07/2023] [Indexed: 02/17/2023] Open
Abstract
Objectives: To assess quality of life or factors related to the foot and general health and to determine the impact taking into account foot health status in people with multiple sclerosis (MS). Methods: 50 subjects with MS and 50 healthy subjects were studied using the Foot Health Status Questionnaire, that is a validated and is reliable tool was used to assess foot health and quality of life. This instrument comprise four domains for evaluate the foot health (foot function, foot pain, footwear and general foot health) in the first section and for measure the general health comprise four domains (general health, physical activity, social capacity and vigor) for second section and was use for all participants. Results: In both groups of the sample, 50% (n = 15) were men and 50% (n = 35) women, and the mean age in the case group was 48.04 ± 10.49 and the control group was 48.04 ± 10.45 were recruited. A statistically significant difference (p < 0.05) was shown for foot function, general foot health, general health, physical activity and vigor domains, stating that people with MS have a lower related to foot health (lower FHSQ scores) compared to healthy subjects who have higher FHSQ scores. There were no statistically significant differences (p > 0.05) for the scores of the other domains of the FHSQ (foot pain, footwear and social capacity). Conclusion: Patients with MS suffer a negative impact on the quality of life related to foot health, which appears to be associated with the chronic disease.
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Affiliation(s)
- Francisco Javier Ruiz-Sánchez
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, Ferrol, Spain
| | - Maria do Rosário Martins
- UICISA: E, Instituto Politécnico de Viana do Castelo, Escola Superior de Saúde, Viana do Castelo, Portugal
| | | | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Universidad de Huelva, Huelva, Spain.,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | | | - Ana María Jiménez-Cebrián
- Nursing and Podiatry Department, University of Málaga, Málaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, Ferrol, Spain
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Brognara L, Mafla-España MA, Gil-Molina I, Castillo-Verdejo Y, Cauli O. The Effects of 3D Custom Foot Orthotics with Mechanical Plantar Stimulation in Older Individuals with Cognitive Impairment: A Pilot Study. Brain Sci 2022; 12:brainsci12121669. [PMID: 36552129 PMCID: PMC9775314 DOI: 10.3390/brainsci12121669] [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: 11/17/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Recent scientific evidence supports the idea that foot plantar stimulation increases the functional connectivity of brain regions involved in visuo-spatial and sensory-motor integration. In this before−after, non-randomised intervention study we assessed the change in several gait and postural parameters using inertial sensor measurements after acute plantar stimulation using custom 3D-printed insoles. The pilot study was performed on 22 institutionalised, older individuals with a high comorbidity burden who either walked autonomously or with the help of a cane. The intensity of the effects in the first mechanical plantar stimulation session (at one week) strongly predicted a change in the 180° turn duration (p < 0.05) and the standard deviation of the step duration (p < 0.05) during the timed up-and-go test. Based on these effects, researchers also predicted decreases in some postural parameters such as the root mean square of displacement on the anterior−posterior axis (p < 0.01). Thus, these preliminary findings provide a strong rationale for performing controlled clinical trials with larger samples to investigate the efficacy and mechanisms of mechanical plantar stimulation in frail elderly individuals.
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Affiliation(s)
- Lorenzo Brognara
- Department of Biomedical and Neuromotor Science, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy
- Correspondence:
| | - Mayra Alejandra Mafla-España
- Frailty and Cognitive Impairment Organized Group, University of Valencia, 46010 Valencia, Spain
- Department of Nursing, University of Valencia, Jaume Roig s/n, 46010 Valencia, Spain
| | | | | | - Omar Cauli
- Frailty and Cognitive Impairment Organized Group, University of Valencia, 46010 Valencia, Spain
- Department of Nursing, University of Valencia, Jaume Roig s/n, 46010 Valencia, Spain
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20
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An Ayurvedic approach to sustaining and pampering the feet of healthcare workers. JOURNAL OF INTERPROFESSIONAL EDUCATION & PRACTICE 2022; 29:100576. [PMID: 36440089 PMCID: PMC9676917 DOI: 10.1016/j.xjep.2022.100576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/26/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022]
Abstract
The COVID-19 pandemic caused imbalances in the lives of healthcare workers to a great degree, leading to long hours on the feet without time for sustained rest and rejuvenation. Ayurvedic wisdom provides a holistic lens from which to view the importance of footcare, which ultimately affects the systemic being. To reduce suffering on all levels, it is important to dedicate time, daily, to the use of doshic-specific self-care techniques. This article offers a daily footcare ritual in support of mind, body, and spiritual health through application of oiling, massage, gratitude, and a yoga-based inversion.
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21
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Elboim-Gabyzon M, Pitluk M, Shuper Engelhard E. The correlation between physical and emotional stabilities: a cross-sectional observational preliminary study. Ann Med 2022; 54:1678-1685. [PMID: 35695561 PMCID: PMC9225739 DOI: 10.1080/07853890.2022.2056241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Postural stability and gait are affected by an individual's emotional state. Physical therapy practice does not usually include an explicit assessment of the individual's emotional status. In contrast, complementary movement therapies often include the assessment of "grounding quality", which refers to the individual's physical and emotional stabilities. This study examined the correlation between conventional physical stability measures and grounding quality. METHOD A computerized balance board and an inertial sensor system measured the postural stability and gait parameters of 36 healthy volunteers (aged 19-35 years). Grounding was assessed using an observation-based assessment tool (Grounding Assessment Tool [GAT]). Spearman's correlation and Cohen's standard were used to assess correlation. RESULTS No correlation was observed between gait parameters and GAT scores. However, significant negative moderate correlations were noted between postural sway measures and scores of several GAT items in the more demanding stance conditions. CONCLUSION Although grounding quality and sway measures are somewhat correlated, they focus on different aspects of movement stability. A comprehensive assessment and holistic intervention strategies require incorporating multiple approaches to stability assessment. Further research is necessary to determine the contribution of combining these approaches among individuals with balance impairments.KEY MESSAGESGait stability measures were not correlated to "grounding quality" (a measure of emotional regulation and emotional awareness).Postural sway measures were found to be correlated to "grounding quality" items in the more demanding stance conditions.A comprehensive evaluation of an individual's stability may facilitate reliable and valid objective measurement instruments for both physical and emotional aspects of the movement.
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Affiliation(s)
- Michal Elboim-Gabyzon
- Physical Therapy Department, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Michal Pitluk
- Faculty of Social Welfare & Health Sciences, Graduate School of Creative Art Therapies, Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
| | - Einat Shuper Engelhard
- Faculty of Social Welfare & Health Sciences, Graduate School of Creative Art Therapies, Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel.,Faculty of Humanities & Social Sciences, Graduate School of Creative Art Therapies, Kibbutzim College of Education, Tel Aviv, Israel
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22
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de Bengy AF, Decorps J, Martin LS, Pagnon A, Chevalier FP, Sigaudo-Roussel D, Fromy B. Alpha-Lipoic Acid Supplementation Restores Early Age-Related Sensory and Endothelial Dysfunction in the Skin. Biomedicines 2022; 10:2887. [PMID: 36359407 PMCID: PMC9687533 DOI: 10.3390/biomedicines10112887] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/02/2022] [Accepted: 11/08/2022] [Indexed: 09/13/2024] Open
Abstract
Many changes characterize skin aging, and the resulting dysfunctions still constitute a real challenge for our society. The aim of this study was to compare the skin aging of two rat strains, Wistar and Brown Norway (BN), considered as "poorly aging" and "healthy aging" models, respectively, and to assess the effect of alpha-lipoic acid (LPA), especially on skin microcirculation. To this purpose, various skin characteristics were studied at 6, 12, and 24 months and compared to the results of LPA treatment performed at 12 or 24 months. Skin aging occurred in both strains, but we showed an early occurrence of different age-related disorders in the Wistar strain compared to BN strain, especially regarding weight gain, glycemia dysregulation, basal skin perfusion, endothelial function, and skin resistance to low pressure. LPA treatment tended to improve skin resistance to low pressure in BN but not in Wistar despite the improvement of basal skin perfusion, endothelial function, and skin sensory sensitivity. Overall, this study confirmed the healthier aging of BN compared to Wistar strain and the positive effect of LPA on both general state and skin microcirculation.
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Affiliation(s)
| | - Johanna Decorps
- CNRS, LBTI UMR5305, Univ. Lyon, Université Claude Bernard Lyon 1, 7 Passage du Vercors, CEDEX 7, 69367 Lyon, France
| | - Lisa S. Martin
- CNRS, LBTI UMR5305, Univ. Lyon, Université Claude Bernard Lyon 1, 7 Passage du Vercors, CEDEX 7, 69367 Lyon, France
| | - Aurélie Pagnon
- Novotec Labs, ZAC du Chêne, Europarc, 11 rue Edison, 69500 Bron, France
| | - Fabien P. Chevalier
- CNRS, LBTI UMR5305, Univ. Lyon, Université Claude Bernard Lyon 1, 7 Passage du Vercors, CEDEX 7, 69367 Lyon, France
| | - Dominique Sigaudo-Roussel
- CNRS, LBTI UMR5305, Univ. Lyon, Université Claude Bernard Lyon 1, 7 Passage du Vercors, CEDEX 7, 69367 Lyon, France
| | - Bérengère Fromy
- CNRS, LBTI UMR5305, Univ. Lyon, Université Claude Bernard Lyon 1, 7 Passage du Vercors, CEDEX 7, 69367 Lyon, France
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Wynands B, Zippenfennig C, Holowka NB, Lieberman DE, Milani TL. Does plantar skin abrasion affect cutaneous mechanosensation? Physiol Rep 2022; 10:e15479. [PMID: 36259120 PMCID: PMC9579735 DOI: 10.14814/phy2.15479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/31/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023] Open
Abstract
In humans, plantar cutaneous mechanoreceptors provide critical input signals for postural control during walking and running. Because these receptors are located within the dermis, the mechanical properties of the overlying epidermis likely affect the transmission of external stimuli. Epidermal layers are highly adaptable and can form hard and thick protective calluses, but their effects on plantar sensitivity are currently disputed. Some research has shown no effect of epidermal properties on sensitivity to vibrations, whereas other research suggests that vibration and touch sensitivity diminishes with a thicker and harder epidermis. To address this conflict, we conducted an intervention study where 26 participants underwent a callus abrasion while an age-matched control group (n = 16) received no treatment. Skin hardness and thickness as well as vibration perception thresholds and touch sensitivity thresholds were collected before and after the intervention. The Callus abrasion significantly decreased skin properties. The intervention group exhibited no change in vibration sensitivity but had significantly better touch sensitivity. We argue that touch sensitivity was impeded by calluses because hard skin disperses the monofilament's standardized pressure used to stimulate the mechanoreceptors over a larger area, decreasing indentation depth and therefore stimulus intensity. However, vibration sensitivity was unaffected because the vibrating probe was adjusted to reach specific indentation depths, and thus stimulus intensity was not affected by skin properties. Since objects underfoot necessarily indent plantar skin during weight-bearing, calluses should not affect mechanosensation during standing, walking, or running.
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Affiliation(s)
- Bert Wynands
- Department of Human Locomotion, Institute of Human Movement Science and HealthChemnitz University of TechnologyChemnitzGermany
| | - Claudio Zippenfennig
- Department of Human Locomotion, Institute of Human Movement Science and HealthChemnitz University of TechnologyChemnitzGermany
| | - Nicholas B. Holowka
- Department of Anthropology, College of Arts and SciencesUniversity at BuffaloBuffaloNew YorkUSA
| | - Daniel E. Lieberman
- Department of Human Evolutionary BiologyHarvard UniversityCambridgeMassachusettsUSA
| | - Thomas L. Milani
- Department of Human Locomotion, Institute of Human Movement Science and HealthChemnitz University of TechnologyChemnitzGermany
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24
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Grabowska W, Burton W, Kowalski MH, Vining R, Long CR, Lisi A, Hausdorff JM, Manor B, Muñoz-Vergara D, Wayne PM. A systematic review of chiropractic care for fall prevention: rationale, state of the evidence, and recommendations for future research. BMC Musculoskelet Disord 2022; 23:844. [PMID: 36064383 PMCID: PMC9442928 DOI: 10.1186/s12891-022-05783-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Falls in older adults are a significant and growing public health concern. There are multiple risk factors associated with falls that may be addressed within the scope of chiropractic training and licensure. Few attempts have been made to summarize existing evidence on multimodal chiropractic care and fall risk mitigation. Therefore, the broad purpose of this review was to summarize this research to date. BODY: Systematic review was conducted following PRISMA guidelines. Databases searched included PubMed, Embase, Cochrane Library, PEDro, and Index of Chiropractic Literature. Eligible study designs included randomized controlled trials (RCT), prospective non-randomized controlled, observational, and cross-over studies in which multimodal chiropractic care was the primary intervention and changes in gait, balance and/or falls were outcomes. Risk of bias was also assessed using the 8-item Cochrane Collaboration Tool. The original search yielded 889 articles; 21 met final eligibility including 10 RCTs. One study directly measured the frequency of falls (underpowered secondary outcome) while most studies assessed short-term measurements of gait and balance. The overall methodological quality of identified studies and findings were mixed, limiting interpretation regarding the potential impact of chiropractic care on fall risk to qualitative synthesis. CONCLUSION Little high-quality research has been published to inform how multimodal chiropractic care can best address and positively influence fall prevention. We propose strategies for building an evidence base to inform the role of multimodal chiropractic care in fall prevention and outline recommendations for future research to fill current evidence gaps.
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Affiliation(s)
- Weronika Grabowska
- Brigham and Women's Hospital and Harvard Medical School Division of Preventive Medicine, Osher Center for Integrative Medicine, 900 Commonwealth Avenue, 3rd Floor, Boston, MA, 02215, USA
| | - Wren Burton
- Brigham and Women's Hospital and Harvard Medical School Division of Preventive Medicine, Osher Center for Integrative Medicine, 900 Commonwealth Avenue, 3rd Floor, Boston, MA, 02215, USA.
| | - Matthew H Kowalski
- Osher Clinical Center for Integrative Medicine, Brigham and Women's Healthcare Center, 850 Boylston Street, Suite 422, Chestnut Hill, MA, 02445, USA
| | - Robert Vining
- Palmer Center for Chiropractic Research, 1000 Brady Street, Davenport, IA, 52803, USA
| | - Cynthia R Long
- Palmer Center for Chiropractic Research, 1000 Brady Street, Davenport, IA, 52803, USA
| | - Anthony Lisi
- Yale University Center for Medical Informatics, 300 George Street, Suite 501, New Haven, CT, USA
| | - Jeffrey M Hausdorff
- Center for the Study of Movement Cognition and Mobility, Tel Aviv Sourasky Medical Center, Dafna St 5, Tel Aviv-Yafo, Israel
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research, 1200 Centre Street, Boston, MA, 02131, USA
| | - Dennis Muñoz-Vergara
- Brigham and Women's Hospital and Harvard Medical School Division of Preventive Medicine, Osher Center for Integrative Medicine, 900 Commonwealth Avenue, 3rd Floor, Boston, MA, 02215, USA
| | - Peter M Wayne
- Brigham and Women's Hospital and Harvard Medical School Division of Preventive Medicine, Osher Center for Integrative Medicine, 900 Commonwealth Avenue, 3rd Floor, Boston, MA, 02215, USA
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Sozzi S, Do MC, Schieppati M. Vertical ground reaction force oscillation during standing on hard and compliant surfaces: The “postural rhythm”. Front Neurol 2022; 13:975752. [PMID: 36119676 PMCID: PMC9475112 DOI: 10.3389/fneur.2022.975752] [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: 06/23/2022] [Accepted: 08/10/2022] [Indexed: 11/14/2022] Open
Abstract
When a person stands upright quietly, the position of the Centre of Mass (CoM), the vertical force acting on the ground and the geometrical configuration of body segments is accurately controlled around to the direction of gravity by multiple feedback mechanisms and by integrative brain centres that coordinate multi-joint movements. This is not always easy and the postural muscles continuously produce appropriate torques, recorded as ground reaction force by a force platform. We studied 23 young adults during a 90 s period, standing at ease on a hard (Solid) and on a compliant support (Foam) with eyes open (EO) and with eyes closed (EC), focusing on the vertical component of the ground reaction force (VGRF). Analysis of VGRF time series gave the amplitude of their rhythmic oscillations (the root mean square, RMS) and of their frequency spectrum. Sway Area and Path Length of the Centre of Pressure (CoP) were also calculated. VGRF RMS (as well as CoP sway measures) increased in the order EO Solid ≈ EC Solid < EO Foam < EC Foam. The VGRF frequency spectra featured prevailing frequencies around 4–5 Hz under all tested conditions, slightly higher on Solid than Foam support. Around that value, the VGRF frequencies varied in a larger range on hard than on compliant support. Sway Area and Path Length were inversely related to the prevailing VGRF frequency. Vision compared to no-vision decreased Sway Area and Path Length and VGRF RMS on Foam support. However, no significant effect of vision was found on VGRF mean frequency for either base of support condition. A description of the VGRF, at the interface between balance control mechanisms and sway of the CoP, can contribute information on how upright balance is maintained. Analysis of the frequency pattern of VGRF oscillations and its role in the maintenance of upright stance should complement the traditional measures of CoP excursions in the horizontal plane.
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Affiliation(s)
- Stefania Sozzi
- Istituti Clinici Scientifici Maugeri IRCCS, Centro Studi Attività Motorie (CSAM), Pavia, Italy
| | - Manh-Cuong Do
- Complexité, Innovation, Activités Motrices et Sportives (CIAMS), Université Paris-Saclay, Orsay, France
- Complexité, Innovation, Activités Motrices et Sportives (CIAMS), Université d'Orléans, Orléans, France
| | - Marco Schieppati
- Istituti Clinici Scientifici Maugeri IRCCS, Centro Studi Attività Motorie (CSAM), Pavia, Italy
- *Correspondence: Marco Schieppati ;
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26
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Diferentes intervenções de fisioterapia na melhora da sensibilidade plantar e equilíbrio de idosas. PAJAR - PAN AMERICAN JOURNAL OF AGING RESEARCH 2022. [DOI: 10.15448/2357-9641.2022.1.42885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objetivo: comparar os efeitos de dois diferentes protocolos de fisioterapia no tratamento da sensibilidade plantar e equilíbrio em idosas da comunidade do município de Panambi. Métodos: ensaio clínico piloto, quantitativo e descritivo. As participantes responderam questionário sobre condições de saúde e autopercepção de sensibilidade plantar. Após, passaram por avaliação da sensibilidade plantar com estesiômetro Semmes-Weinstein. Foram selecionadas apenas idosas com sensibilidade diminuída. O equilíbrio foi avaliado através da Escala de Equilíbrio de Berg e teste Timed Up and Go. As 13 participantes selecionadas foram divididas em grupo sensibilidade plantar e grupo proprioceptivo, com a realização de 10 intervenções com cada grupo, com estímulo específico conforme alocação nos grupos. Após houve a reavaliação das participantes com estesiômetro, Escala de Equilíbrio de Berg e Timed Up and Go. As comparações das variáveis quantitativas foram realizadas através do teste t de Student, com nível de significância adotado de 5% (p<0,05). Resultados: 12 idosas concluíram o estudo, porém apenas cinco relataram perceber diminuição de sensibilidade plantar. As regiões plantares com maior perda de sensibilidade foram nos metatarsos, região lateral do pé e calcâneo. Já a região medial, apresentou menor perda sensorial. Após os treinos, ambos os grupos mostraram melhora estatisticamente significativa na sensibilidade plantar. Já no equilíbrio, o grupo sensibilidade plantar apresentou resultados estatisticamente significativos no teste Timed Up and Go e o grupo proprioceptivo na Escala de Equilíbrio de Berg. Conclusão: os treinos mostraram-se efetivos na sensibilidade plantar e equilíbrio das participantes, indicando que a combinação dessas intervenções no tratamento do controle postural é uma boa opção para fisioterapeutas.
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Robb KA, Perry SD. The effect of texture under distinct regions of the foot sole on human locomotion. Exp Brain Res 2022; 240:2175-2189. [PMID: 35771285 DOI: 10.1007/s00221-022-06402-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/16/2022] [Indexed: 11/29/2022]
Abstract
Sensory feedback from the foot sole plays an important role in shaping human locomotion. While net muscle activity and kinematic changes have been correlated with electrical stimulation to five topographical regions of the foot, it remains unknown if these responses are similar with tactile stimulation. The purpose of this study was to use texture in foot orthosis design, applied to five distinct regions under the foot sole, and measure joint kinematics, location of center of pressure, and muscle activity of eight lower leg muscles during level and incline walking. Fifty-five healthy adults completed 48 walking trials in textured and non-textured foot orthoses. Study results confirm that tactile stimulation is stimulation-site and gait-phase specific in modulating lower leg muscle activity during walking. For example, texture under the lateral forefoot consistently generated a suppression of EMG and texture under the lateral midfoot always generated a facilitation. In early stance, adding texture under the medial midfoot or calcaneus facilitated extensor muscle activity and suppressed flexor muscle activity. Texture under the lateral midfoot or medial forefoot facilitated tibialis posterior activation. These results support the topographical organization of cutaneous mechanoreceptors in foot sole skin while considering how texture can be used in foot orthosis design to target lower leg muscular changes during locomotion.
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Affiliation(s)
- Kelly A Robb
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, 75 University Ave. West, Waterloo, ON, N2L 3C5, Canada.
| | - Stephen D Perry
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, 75 University Ave. West, Waterloo, ON, N2L 3C5, Canada
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28
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Viseux FJF, Simoneau M, Billot M. A Comprehensive Review of Pain Interference on Postural Control: From Experimental to Chronic Pain. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060812. [PMID: 35744075 PMCID: PMC9230450 DOI: 10.3390/medicina58060812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022]
Abstract
Motor control, movement impairment, and postural control recovery targeted in rehabilitation could be affected by pain. The main objective of this comprehensive review is to provide a synthesis of the effect of experimental and chronic pain on postural control throughout the available literature. After presenting the neurophysiological pathways of pain, we demonstrated that pain, preferentially localized in the lower back or in the leg induced postural control alteration. Although proprioceptive and cortical excitability seem modified with pain, spinal modulation assessment might provide a new understanding of the pain phenomenon related to postural control. The literature highlights that the motor control of trunk muscles in patient presenting with lower back pain could be dichotomized in two populations, where the first over-activates the trunk muscles, and the second under-activates the trunk muscles; both generate an increase in tissue loading. Taking all these findings into account will help clinician to provide adapted treatment for managing both pain and postural control.
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Affiliation(s)
- Frédéric J. F. Viseux
- Centre d’Evaluation et de Traitement de la Douleur (CETD), Hôpital Jean Bernard, Centre Hospitalier de Valenciennes, F-59322 Valenciennes, France
- Département Sciences de l’Homme et du Vivant (SHV), Université Polytechnique Hauts-de-France (UPHF), LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France
- Correspondence:
| | - Martin Simoneau
- Département de Kinésiologie, Faculté de Médecine, Université Laval, Québec, QC G1V 0A6, Canada;
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS) du CIUSSS de la Capitale Nationale, Québec, QC G1M 2S8, Canada
| | - Maxime Billot
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, F-86000 Poitiers, France;
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29
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Estepa-Gallego A, Ibañez-Vera AJ, Estudillo-Martínez MD, Castellote-Caballero Y, Bergamin M, Gobbo S, Lérida-Ortega MÁ, Cruz-Díaz D. Effects of global postural reeducation on postural control, dynamic balance, and ankle range of motion in patients with hallux abducto valgus. A randomized controlled trial. J Orthop Res 2022; 40:1436-1445. [PMID: 34370331 DOI: 10.1002/jor.25156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/16/2021] [Accepted: 07/30/2021] [Indexed: 02/04/2023]
Abstract
Hallux abducto valgus (HAV) is a common musculoskeletal disorder that has been addressed surgically. Nevertheless, the manual therapy approach may play an important role in the management of this condition. The present study aimed to determine the effectiveness of global postural reeducation (GPR) in subjects with symptomatic mild to moderate HAV in static postural control, dynamic stability, and ankle dorsiflexion range of motion (DFROM). A total of 80 patients with mild to moderate symptomatic HAV were allocated to the intervention group (GPR) or control group (CG) (no treatment) for 8 weeks. Outcome measures were assessed at baseline at 4 and 8 weeks including static postural control (Romberg test), dynamic balance (Star Excursion Balance Test [SEBT]), and ankle DFROM (Weight-Bearing Lunge Test [WBLT]). No improvements were observed at 4 weeks, but there were improvements at 8 weeks in: static postural control mediolateral displacement (X) of center of pressure (CoP) in both eyes open (EO) and eyes closed (EC): XEO (t(36) = 2.892, p = .006, d = 0.67); XEC (t(68) = 2.280, p = .026, d = 054); and velocity (V) of CoP displacement: VEO (t(68) = 2.380, p = .020, d = 0.57); VEC (t(36) = 2.057, p = .047, d = 0.37). It were also improvements in: WBLT (t(36) = -2.869, p = .007, d = 0.54) and SEBT at three directions (anterior, ANT; posteromedial, PM; and posterolateral, PL): SEBT.ANT (t(36) = -2.292, p = .028, d = 0.23); SEBT.PM (t(36) = -4.075, p < .001, d = 0.43); SEBT.PL (t(62) = -3.506, p = .001, d = 0.34). The present study showed that GPR compared to the CG might be effective in enhancing ankle function including postural control, dynamic balance, and DFROM.
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Affiliation(s)
| | | | | | | | - Marco Bergamin
- Department of Medicine, University of Padova Palazzina ex SemeioticaMedica-Via Ospedale Civile, Padova, Italy
| | - Stefano Gobbo
- Department of Medicine, University of Padova Palazzina ex SemeioticaMedica-Via Ospedale Civile, Padova, Italy
| | | | - David Cruz-Díaz
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain.,Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, Universidad de Murcia, Murcia, Spain
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30
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Machado MS, Machado ÁS, Guadagnin EC, Schmidt D, Germano AMC, Carpes FP. Effects of increasing temperature in different foot regions on foot sensitivity and postural control in young adults. Foot (Edinb) 2022; 50:101887. [PMID: 35219134 DOI: 10.1016/j.foot.2021.101887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/13/2021] [Accepted: 11/18/2021] [Indexed: 02/04/2023]
Abstract
Despite controversial evidence, foot sensitivity may influence postural control. Since skin temperature changes may induce changes in skin sensitivity, it remains unclear whether this also affects postural control. Here we examined the effects of increasing foot temperature on foot sensitivity and postural control responses. It is hypothesized that increases in foot temperature would improve foot sensitivity and enhance postural control. Furthermore, it was investigated whether warming a larger foot area provides additional benefits. Our hypothesis was tested by warming the foot plantar and the whole foot and ankle area (including foot plantar and instep) using infrared radiation and evaluated the center of pressure (CoP, bilateral, in two conditions: eyes open and eyes closed) and foot tactile sensitivity (Semmes-Weinstein Monofilaments) in 22 young participants. Both warming protocols significantly increased foot temperature by ∼5-6 °C and improved sensitivity, whereas more considerable improvements happened after warming the whole foot and ankle. CoP mediolateral oscillation and velocity with eyes open, and CoP area and velocity with eyes closed reduced after both warming protocols. Foot sensitivity seems to depend on the foot area warmed, whereas postural control improved equally regardless of the warmed regions. These results may support interventions based on the manipulation of foot temperatures to improve postural control with potential clinical applications in populations with impaired foot sensitivity and balance.
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Affiliation(s)
- Mathias S Machado
- Applied Neuromechanics Research Group, Federal University of Pampa, Uruguaiana, RS, Brazil
| | - Álvaro S Machado
- Applied Neuromechanics Research Group, Federal University of Pampa, Uruguaiana, RS, Brazil
| | - Eliane C Guadagnin
- Applied Neuromechanics Research Group, Federal University of Pampa, Uruguaiana, RS, Brazil
| | - Daniel Schmidt
- Department of Human Locomotion, Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Andresa M C Germano
- Department of Human Locomotion, Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Felipe P Carpes
- Applied Neuromechanics Research Group, Federal University of Pampa, Uruguaiana, RS, Brazil.
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Ankle complex proprioception and plantar cutaneous sensation in older women with different physical activity levels. Exp Brain Res 2022; 240:981-989. [DOI: 10.1007/s00221-021-06273-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 11/11/2021] [Indexed: 11/04/2022]
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Seth M, Beisheim-Ryan EH, Pohlig RT, Horne JR, Hicks GE, Sions JM. Vibration Sensitivity Is Associated With Functional Balance After Unilateral Transtibial Amputation. Arch Rehabil Res Clin Transl 2022; 3:100161. [PMID: 34977543 PMCID: PMC8683871 DOI: 10.1016/j.arrct.2021.100161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objectives To evaluate differences in vibration perception thresholds between adults with transtibial amputation and age-matched adults without amputation and to examine associations between vibration perception thresholds and balance performance. We hypothesized that adults with transtibial amputation would demonstrate lower thresholds compared with adults without amputation and that lower thresholds would be associated with better functional balance. Design Prospective cross-sectional study. Setting National conference, clinical practice, and university laboratory. Participants Adults (N=34) with a nondysvascular, unilateral, transtibial amputation and 43 age-matched controls without amputation. Interventions Participants' vibration perception thresholds were evaluated bilaterally by applying a vibration stimulus to the midpatella and recording their verbal response to conscious perception of stimulus. Functional balance was assessed with the Berg Balance Scale and the Four Square Step Test. Main Outcome Measures Residual and sound limb (right and left for controls) vibration perception thresholds, Berg Balance Scale, and Four Square Step Test. Results For participants with transtibial amputation and controls, there were no significant between-group (P=.921) or interlimb (P=.540) differences in vibration perception thresholds. Overall, robust regression models explained 35.1% and 19.3% variance in Berg Balance Scale scores and Four Square Step Test times, respectively. Among adults with transtibial amputation, vibration perception thresholds were negatively associated with Berg Balance Scale scores (P=.009) and positively associated with Four Square Step Test times (P=.048). Among controls, average vibration perception thresholds were not significantly associated with functional balance (P>.050). Conclusions Adults with nondysvascular, transtibial-level amputation demonstrated similar vibration detection compared with adults with intact limbs, indicating that vibration detection is preserved in the amputated region postamputation. These findings suggest a unique relationship between vibration perception and functional balance post-transtibial amputation.
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Affiliation(s)
- Mayank Seth
- Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, Newark DE
| | - Emma H Beisheim-Ryan
- Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, Newark DE
| | - Ryan T Pohlig
- Biostatistics Core, University of Delaware, Newark, DE
| | | | - Gregory E Hicks
- Delaware Spine Studies, Department of Physical Therapy, University of Delaware, Newark DE
| | - Jaclyn M Sions
- Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, Newark DE
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Wound Healing and Therapy in Soft Tissue Defects of the Hand and Foot from a Surgical Point of View. Med Sci (Basel) 2021; 9:medsci9040071. [PMID: 34842788 PMCID: PMC8628974 DOI: 10.3390/medsci9040071] [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: 10/31/2021] [Accepted: 11/10/2021] [Indexed: 01/02/2023] Open
Abstract
Wounds and tissue defects of the hand and foot often lead to severe functional impairment of the affected extremity. Next to general principles of wound healing, special functional and anatomic considerations must be taken into account in the treatment of wounds in these anatomical regions to achieve a satisfactory reconstructive result. In this article, we outline the concept of wound healing and focus on the special aspects to be considered in wounds of the hand and foot. An overview of different treatment and dressing techniques is given with special emphasis on the reconstruction of damaged structures by plastic surgical means.
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Tigrini A, Verdini F, Fioretti S, Mengarelli A. Center of pressure plausibility for the double-link human stance model under the intermittent control paradigm. J Biomech 2021; 128:110725. [PMID: 34509911 DOI: 10.1016/j.jbiomech.2021.110725] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/09/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
Despite human balance maintenance in quiet conditions could seem a trivial motor task, it is not. Recently, the human stance was described through a double link inverted pendulum (DIP) actively controlled at the ankle with an intermittent proportional (P) and derivative (D) control actions based on the sway of a virtual inverted pendulum (VIP) that links the ankle joint with the DIP center of mass. Such description, encompassing both the mechanical model and the intermittent control policy, was referred as the DIP/VIP human stance model, and it showed physiologically plausible kinematic patterns. In this study a mathematical formalization of the Center of pressure (COP) for a DIP structure was developed. Then, it was used in conjunction with an intermittently controlled DIP/VIP model to assess its kinetic plausibility. Three descriptors commonly employed in posturography were selected among six based on their capability to discriminate between young (Y) and elderly (O) adults groups. Then, they were applied to assess whether variations of the P-D parameters affect the synthetic COP. The results showed that DIP/VIP model can reproduce COP trajectories, showing characteristics similar to the Y and O groups. Moreover, it was observed that both P and D parameters increased passing from Y to O, indicating that the COP obtained from the DIP/VIP model is able to highlight differences in balance control between groups. The study hence promote the use of DIP/VIP in posturography, where inferential techniques can be applied to characterize neural control.
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Affiliation(s)
- Andrea Tigrini
- Department of Information Engineering, Università Politecnica delle Marche, 60131, Ancona, Italy.
| | - Federica Verdini
- Department of Information Engineering, Università Politecnica delle Marche, 60131, Ancona, Italy.
| | - Sandro Fioretti
- Department of Information Engineering, Università Politecnica delle Marche, 60131, Ancona, Italy.
| | - Alessandro Mengarelli
- Department of Information Engineering, Università Politecnica delle Marche, 60131, Ancona, Italy.
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Lauzier L, Kadri MA, Bouchard E, Bouchard K, Gaboury S, Gagnon JM, Girard MP, Larouche A, Robert R, Lapointe P, da Silva RA, Beaulieu LD. Vibration of the Whole Foot Soles Surface Using an Inexpensive Portable Device to Investigate Age-Related Alterations of Postural Control. Front Hum Neurosci 2021; 15:719502. [PMID: 34566603 PMCID: PMC8461065 DOI: 10.3389/fnhum.2021.719502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/18/2021] [Indexed: 11/14/2022] Open
Abstract
Background: Standing on a foam surface is used to investigate how aging affect the ability to keep balance when somatosensory inputs from feet soles become unreliable. However, since standing on foam also affects the efficacy of postural adjustments, the respective contributions of sensory and motor components are impossible to separate. This study tested the hypothesis that these components can be untangled by comparing changes of center of pressure (CoP) parameters induced by standing on a foam pad vs. a novel vibration (VIB) platform developed by our team and targeting feet soles’ mechanoreceptors. Methods: Bipedal postural control of young (n = 20) and healthy elders (n = 20) was assessed while standing barefoot on a force platform through 3 randomized conditions: (1) Baseline (BL); (2) VIB; and (3) Foam. CoP Amplitude and Velocity in the antero-posterior/medio-lateral (AP/ML) directions and COP Surface were compared between conditions and groups. Findings: Both VIB and Foam increased CoP parameters compared to BL, but Foam had a significantly greater impact than VIB for both groups. Young and Old participants significantly differed for all three Conditions. However, when correcting for BL levels of postural performance, VIB-related increase of COP parameters was no longer different between groups, conversely to Foam. Interpretation: Although both VIB and Foam highlighted age-related differences of postural control, their combined use revealed that “motor” and “sensory” components are differently affected by aging, the latter being relatively unaltered, at least in healthy/active elders. The combined used of these methods could provide relevant knowledge to better understand and manage postural impairments in the aging population.
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Affiliation(s)
- Lydiane Lauzier
- Laboratoire de Recherche Biomécanique & Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Centre Intersectoriel en Santé Durable, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Mohamed Abdelhafid Kadri
- Laboratoire de Recherche Biomécanique & Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Centre Intersectoriel en Santé Durable, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Emilie Bouchard
- Laboratoire de Recherche Biomécanique & Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Centre Intersectoriel en Santé Durable, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Kevin Bouchard
- Laboratoire d'Intelligence Ambiante pour la Reconnaissance d'Activités (LIARA), Centre Intersectoriel en Santé Durable, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Sébastien Gaboury
- Laboratoire d'Intelligence Ambiante pour la Reconnaissance d'Activités (LIARA), Centre Intersectoriel en Santé Durable, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Jean-Michel Gagnon
- Laboratoire de Recherche Biomécanique & Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Centre Intersectoriel en Santé Durable, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Marie-Pier Girard
- Laboratoire de Recherche Biomécanique & Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Centre Intersectoriel en Santé Durable, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Andréanne Larouche
- Laboratoire de Recherche Biomécanique & Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Centre Intersectoriel en Santé Durable, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Roxane Robert
- Laboratoire de Recherche Biomécanique & Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Centre Intersectoriel en Santé Durable, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Patrick Lapointe
- Laboratoire d'Intelligence Ambiante pour la Reconnaissance d'Activités (LIARA), Centre Intersectoriel en Santé Durable, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Rubens A da Silva
- Laboratoire de Recherche Biomécanique & Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Centre Intersectoriel en Santé Durable, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada.,Centre Intégré de Santé et Services Sociaux du Saguenay-Lac-Saint-Jean (CIUSSS SLSJ), Hôpital de La Baie, Saguenay, QC, Canada
| | - Louis-David Beaulieu
- Laboratoire de Recherche Biomécanique & Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Centre Intersectoriel en Santé Durable, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
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Lai Z, Pang H, Hu X, Dong K, Wang L. Effects of intrinsic-foot-muscle exercise combined with the lower extremity resistance training on postural stability in older adults with fall risk: study protocol for a randomised controlled trial. Trials 2021; 22:587. [PMID: 34479617 PMCID: PMC8414859 DOI: 10.1186/s13063-021-05554-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 08/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Falls are one of the most common accidents in older adults, often leading to injury, disability and quality-of-life declines. Foot core function contributes to postural stability in most static postures and dynamic activities. As efficient foot core training, the intrinsic-foot-muscle exercise has been proposed to improve postural control. However, the effects of the exercise on postural stability in the elderly remain unclear. Therefore, this study attempts to investigate the effect of 12-week intrinsic-foot-muscle exercise on postural stability in older adults with fall risk. METHODS We will conduct a prospective, single-blind randomised controlled trail on 120 older adults with fall risk. Participants will be randomly assigned to an intrinsic-foot-muscle exercise combining the lower extremity resistance training group (IFM group), an extrinsic-foot-muscle exercise combining the lower extremity resistance training group (EFM group) and a control group. The control group will perform lower extremity resistance training. The IFM and EFM groups will be given additional short-foot exercise or towel-curl exercise training, respectively. After the intervention, participants will be followed up for another 12 weeks with no active intervention. The outcome measures will include the postural stability measurements, self-reported postural stability, number of falls, intrinsic-foot-muscle strength and foot arch function. Furthermore, adverse events will be recorded and analysed. If any participant withdraws from the trial, an intention-to-treat analysis will be performed. DISCUSSION The trial is designed to investigate the efficacy of a 12-week intrinsic foot muscle training combined with the lower extremity resistance training on postural stability outcomes in elderly people with fall risk. The trial will also examine the comprehensive outcomes of postural stability during static standing and dynamic movements. The function of intrinsic foot muscle to support the arch will also be evaluated. Important features of this trial mainly include intervention setting, outcome measure selection and study duration. The results of this study will determine the effectiveness and provide scientific evidence to establish comprehensive fall prevention intervention. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000033623. Registered on 7 June 2020. http://www.chictr.org.cn/showproj.aspx?proj=54741.
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Affiliation(s)
- Zhangqi Lai
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Hongbo Pang
- Tianjin Rehabilitation guidance Center for the Disabledg, Tianjin, China
| | - Xiaoyue Hu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Kun Dong
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Lin Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China.
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Santos AD, Prado-Rico JM, Cirino NTDO, Perracini MR. Are foot deformity and plantar sensitivity impairment associated with physical function of community-dwelling older adults? Braz J Phys Ther 2021; 25:846-853. [PMID: 34535410 DOI: 10.1016/j.bjpt.2021.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 07/15/2021] [Accepted: 07/30/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Foot deformities are highly prevalent in older adults and negatively impact their mobility and quality of life. However, the association between foot problems and physical function is still unclear. OBJECTIVE To investigate whether structural foot deformities and plantar tactile sensitivity are associated with lower extremity physical function impairment in community-dwelling older adults. METHODS We included 200 men and women aged 60 years and older from a community-based program. The foot assessment included toe deformities and calluses inspection and evaluation of plantar tactile sensitivity using monofilaments. The Short Physical Performance Battery (SPPB) was used to assess lower extremity physical function. We conducted a multivariate logistic regression analysis to investigate the association between foot problems and lower extremity physical function. RESULTS Hallux valgus was the most prevalent deformity among older adults. Those participants with reduced plantar tactile sensitivity (OR= 2.77; 95% CI: 1.38, 5.55) and a hallux valgus (OR= 2.23; 95% CI: 1.10, 4.52) were more likely to present poor lower extremity physical function. CONCLUSION Hallux valgus and impaired plantar sensitivity were associated with reduced lower extremity physical function in older adults. Further studies are necessary to identify this causality and to what extent management of these foot problems can improve general mobility and quality of life of older adults.
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Affiliation(s)
- Aurélio Dias Santos
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Janina Manzieri Prado-Rico
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | | | - Monica Rodrigues Perracini
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil; Master's and Doctoral Programs in Gerontology, Faculty of Medicine, Universidade Estadual de Campinas, São Paulo, SP, Brazil.
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Song Q, Zhang X, Mao M, Sun W, Zhang C, Chen Y, Li L. Relationship of proprioception, cutaneous sensitivity, and muscle strength with the balance control among older adults. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:585-593. [PMID: 34293496 PMCID: PMC8500852 DOI: 10.1016/j.jshs.2021.07.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/02/2021] [Accepted: 06/10/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Balance impairment is one of the strongest risk factors for falls. Proprioception, cutaneous sensitivity, and muscle strength are 3 important contributors to balance control in older adults. The relationship that dynamic and static balance control has to proprioception, cutaneous sensitivity, and muscle strength is still unclear. This study was performed to investigate the relationship these contributors have to dynamic and static balance control. METHODS A total of 164 older adults (female = 89, left dominant = 15, age: 73.5 ± 7.8 years, height: 161.6 ± 7.1 cm, weight: 63.7 ± 8.9 kg, mean ± SD) participated in this study. It tested the proprioception of their knee flexion/extension and ankle dorsi/plantarflexion, along with cutaneous sensitivity at the great toe, first and fifth metatarsals, arch, and heel, and the muscle strength of their ankle dorsi/plantarflexion and hip abduction. The Berg Balance Scale (BBS) and the root mean square (RMS) of the center of pressure (CoP) were collected as indications of dynamic and static balance control. A partial correlation was used to determine the relationship between the measured outcomes variables (BBS and CoP-RMS) and the proprioception, cutaneous sensitivity, and muscle strength variables. RESULTS Proprioception of ankle plantarflexion (r = -0.306, p = 0.002) and dorsiflexion (r = -0.217, p = 0.030), and muscle strength of ankle plantarflexion (r = 0.275, p = 0.004), dorsiflexion (r = 0.369, p < 0.001), and hip abduction (r = 0.342, p < 0.001) were weakly to moderately correlated with BBS. Proprioception of ankle dorsiflexion (r = 0.218, p = 0.020) and cutaneous sensitivity at the great toe (r = 0.231, p = 0.041) and arch (r = 0.285, p = 0.002) were weakly correlated with CoP-RMS in the anteroposterior direction. Proprioception of ankle dorsiflexion (r = 0.220, p = 0.035), knee flexion (r = 0.308, p = 0.001) and extension (r = 0.193, p = 0.040), and cutaneous sensitivity at the arch (r = 0.206, p = 0.028) were weakly to moderately correlated with CoP-RMS in the mediolateral direction. CONCLUSION There is a weak-to-moderate relationship between proprioception and dynamic and static balance control, a weak relationship between cutaneous sensitivity and static balance control, and a weak-to-moderate relationship between muscle strength and dynamic balance control.
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Affiliation(s)
- Qipeng Song
- College of Sports and Health, Shandong Sport University, Jinan 250102, China
| | - Xinyan Zhang
- Department of Statistics and Analytical Sciences, Kennesaw State University, Kennesaw, GA 30144, USA
| | - Min Mao
- Department of Allied Health, the University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Wei Sun
- College of Sports and Health, Shandong Sport University, Jinan 250102, China
| | - Cui Zhang
- Lab of Biomechanics, Shandong Institute of Sport Science, Jinan 250102, China
| | - Yan Chen
- College of Sports and Health, Shandong Sport University, Jinan 250102, China
| | - Li Li
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China; Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA 30460, USA.
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Bousbaïne van de Kerckhove L, Lefaucheur JP, Sorel M. Differences in stabilometric correlates of pain relief after wearing postural insoles for six weeks between chronic nociceptive and neuropathic foot pain. An open-label pilot study. Neurophysiol Clin 2021; 51:267-278. [PMID: 34023188 DOI: 10.1016/j.neucli.2021.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/25/2021] [Accepted: 04/25/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine if the use of postural insoles could result in a noticeable reduction in the foot pain intensity in patients with a chronic pain condition, either nociceptive (ankylosing spondylitis, AS) or neuropathic (small fiber neuropathy, SFN). METHOD In this open-label pilot study, patients were asked to wear postural insoles for a continuous period of 6 weeks. The primary endpoint was the mean daily pain intensity at foot mobilization measured using a visual analogue scale (VAS). The secondary endpoints included global pain intensity scores (at rest or under mobilization), clinical questionnaires on pain and daily functioning (including the Brief Pain Inventory (BPI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Neuropathic Pain Symptom Inventory (NPSI) and the DN4 questionnaire), and posturo-podiatric variables assessed on clinical examination or using a baro-stabilometric platform. RESULTS The study was completed by 17 patients with AS and 12 patients with SFN. After wearing postural insoles for 6 weeks, a significant improvement was observed on the primary endpoint (decrease in VAS pain score at the foot during mobilization) in both groups of patients (from 6.4 ± 2.4 to 3.6 ± 2.6 (p = 0.0004) in the AS group and from 5.7 ± 2.2 to 2.4 ± 1.6 (p = 0.0003) in the SFN group). Improvement was also observed for all other pain and activity scores (global pain at rest or during mobilization (VAS), BDI, and BASDAI for the AS group or NPSI and DN4 for the SFN group), as well as for posturo-podiatric clinical variables. However, we did not find any difference in any clinical pain score whether the posturo-podiatric clinical outcomes were positive or not. Regarding the stabilometric measures, the only significant change after the intervention was a reduced mean velocity of center of pressure displacement in the AS group only (mVel in mm/s: from 7.4 ± 2.0 vs. 6.7 ± 1.9, p = 0.017). In addition, the reduction in mVel correlated to that of the BPI score (r = 0.48, p = 0.0496). CONCLUSION In both groups of patients, wearing postural insoles for 6 weeks led to a significant decrease in local pain intensity at foot level and to more global analgesic effects and positive posturo-podiatric changes. However, these latter changes did not appear to be strongly associated with pain relief. Nevertheless, an index of a better postural control, i.e. mVel decrease, was found to be related to a reduction of pain interference in daily life activities in AS patients, but not in SFN patients. Therefore, in the context of neuropathic pain, mechanisms other than postural changes likely contribute to the analgesic effects of wearing postural insoles, in contrast to nociceptive pain due to spinal osteoarthritis.
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Affiliation(s)
- Leïla Bousbaïne van de Kerckhove
- Univ Paris Est Creteil, EA4391, ENT, F-94010 Creteil, France; Osteopathic Office, 123 rue de l'Université, F-75007 Paris, France.
| | - Jean-Pascal Lefaucheur
- Univ Paris Est Creteil, EA4391, ENT, F-94010 Creteil, France; AP-HP, Henri Mondor University Hospital, Clinical Neurophysiology Unit, F-94010 Creteil, France
| | - Marc Sorel
- Univ Paris Est Creteil, EA4391, ENT, F-94010 Creteil, France; CH Sud-Seine-et-Marne, Pain Clinic (Centre d'Evaluation et Traitement de la Douleur), F-77140 Nemours, France
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Tyganov SA, Mochalova E, Belova S, Sharlo K, Rozhkov S, Kalashnikov V, Turtikova O, Mirzoev T, Shenkman B. Plantar mechanical stimulation attenuates protein synthesis decline in disused skeletal muscle via modulation of nitric oxide level. Sci Rep 2021; 11:9806. [PMID: 33963253 PMCID: PMC8105341 DOI: 10.1038/s41598-021-89362-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 04/19/2021] [Indexed: 01/04/2023] Open
Abstract
Both research conducted under microgravity conditions and ground-based space analog studies have shown that air pump-based plantar mechanical stimulation (PMS) of cutaneous mechanoreceptors of the sole of the foot is able to increase neuromuscular activity in the musculature of the lower limbs. This type of stimulation is able to attenuate unloading-induced skeletal muscle atrophy and impaired muscle function. The aim of the present study was to evaluate the effects of PMS on anabolic signaling pathways in rat soleus muscle following 7-day hindlimb suspension (HS) and to elucidate if the effects of PMS on anabolic processes would be NO-dependent. The soles of the feet were stimulated with a frequency of 1-s inflation/1-s deflation with a total of 20 min followed by 10 min rest. This cycle was repeated for 4 h each day. We observed a decrease in the soleus muscle mass after 7-day HS, which was not prevented by PMS. We also observed a decrease in slow-type fiber cross-sectional area (CSA) by 56%, which significantly exceeded a decrease (-22%) in fast-type fiber CSA. PMS prevented a reduction in slow-twitch fiber CSA, but had no effect on fast-twitch fiber CSA. PMS prevented a 63% decrease in protein synthesis after 7-day HS as well as changes in several key anabolic signaling regulators, such as p70S6k, 4E-BP1, GSK3β, eEF-2, p90RSK. PMS also prevented a decrease in the markers of translational capacity (18S and 28S rRNA, c-myc, 45S pre-rRNA). Some effects of PMS on anabolic signaling were altered due to NO-synthase inhibitor (L-NAME) administration. Thus, PMS is able to partially prevent atrophic processes in rat soleus muscle during 7-day HS, affecting slow-type muscle fibers. This effect is mediated by alterations in anabolic signaling pathways and may depend on NO-synthase activity.
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Affiliation(s)
- Sergey A Tyganov
- Myology Laboratory, Institute of Biomedical Problems RAS, Khoroshevskoe shosse 76a, Moscow, Russian Federation, 123007.
| | - Ekaterina Mochalova
- Myology Laboratory, Institute of Biomedical Problems RAS, Khoroshevskoe shosse 76a, Moscow, Russian Federation, 123007
| | - Svetlana Belova
- Myology Laboratory, Institute of Biomedical Problems RAS, Khoroshevskoe shosse 76a, Moscow, Russian Federation, 123007
| | - Kristina Sharlo
- Myology Laboratory, Institute of Biomedical Problems RAS, Khoroshevskoe shosse 76a, Moscow, Russian Federation, 123007
| | - Sergey Rozhkov
- Myology Laboratory, Institute of Biomedical Problems RAS, Khoroshevskoe shosse 76a, Moscow, Russian Federation, 123007
| | - Vitaliy Kalashnikov
- Myology Laboratory, Institute of Biomedical Problems RAS, Khoroshevskoe shosse 76a, Moscow, Russian Federation, 123007
| | - Olga Turtikova
- Myology Laboratory, Institute of Biomedical Problems RAS, Khoroshevskoe shosse 76a, Moscow, Russian Federation, 123007
| | - Timur Mirzoev
- Myology Laboratory, Institute of Biomedical Problems RAS, Khoroshevskoe shosse 76a, Moscow, Russian Federation, 123007
| | - Boris Shenkman
- Myology Laboratory, Institute of Biomedical Problems RAS, Khoroshevskoe shosse 76a, Moscow, Russian Federation, 123007
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41
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Deschamps K, Nester C, Newton V, Gijon-Nogueron G, Simsek E, Brabants A. The biopsychosocial-digital continuum of foot orthosis practice and research: the VALUATOR model. J Foot Ankle Res 2021; 14:25. [PMID: 33789716 PMCID: PMC8011079 DOI: 10.1186/s13047-021-00468-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/22/2021] [Indexed: 02/05/2023] Open
Abstract
Foot orthoses have been used for decades despite uncertainty surrunding their therapeutic efficacy. Orthoses have been used exclusively to affect neuro-biomechanical input and outcome variables, however, there is emerging evidence that therapeutic efficacy may be affected by a psychological stimulus. Critical appraisal of the literature highlights that there is no holistic model upon which foot orthosis practice is taught, practised nor investigated. This paper introduces a conceptual model of foot orthosis practice (Value Based Foot Orthosis Practice (VALUATOR) model) that embraces a broader range of factors that are pertinent to orthosis practice, incorporating contemporary health service behaviours and values into orthosis practice for the first time.Within the VALUATOR model, foot orthosis design and clinical value is considered along a bio-psycho-social-digital continuum that reflects the reality of foot orthosis practice. The model contextualises the variable outcomes that are observed in research and practice within 6 key areas: 1) value, 2) person-centered approach, 3) zone of optimal bio-psycho-social stress, 4) bio-psycho-social assessment, 5) monitoring, 6) primary and secondary clinical strategies.The VALUATOR model is targeted at students, lecturers, scientists and practitioners and includes carefully chosen terminology to support a robust basis for educational and scientific discussion. It is believed that it provides a contemporary viewpoint and a structured conceptual metaphor that builds on existing evidence from a wide range of sources, invites constructive intellectual debate, and is anchored in the experiences of practitioners too. Stress testing the VALUATOR model will help determine its model and support further developments and evolution of orthotic practice in a evidence based way.
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Affiliation(s)
- Kevin Deschamps
- Department of Podiatry, Artevelde University of Applied Sciences, Ghent, Belgium
- KULeuven- Department of Rehabilitation Sciences- Musculoskeletal Rehabilitation, Research Group, Campus Brugge, Spoorwegstraat 12, 8200 Brugge, Belgium
- Haute Ecole Leonard De Vinci, Institut D’Enseignement Supérieur Parnasse Deux-Alice, Division of Podiatry, Bruxelles, Belgium
| | - Chris Nester
- School of Health & Society, Brian Blatchford Building, Frederick Road Campus, University of Salford, Salford, M6 6PU UK
| | - Veronica Newton
- School of Health & Society, Brian Blatchford Building, Frederick Road Campus, University of Salford, Salford, M6 6PU UK
| | | | - Engin Simsek
- School of Physical Therapy and Rehabilitation Sciences, Dokuz Eylul University, İzmir, Turkey
| | - Antoine Brabants
- Haute Ecole Leonard De Vinci, Institut D’Enseignement Supérieur Parnasse Deux-Alice, Division of Podiatry, Bruxelles, Belgium
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Preliminary Evidence That Taping Does Not Optimize Joint Coupling of the Foot and Ankle Joints in Patients with Chronic Ankle Instability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042029. [PMID: 33669704 PMCID: PMC7922002 DOI: 10.3390/ijerph18042029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/06/2021] [Accepted: 02/11/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Foot-ankle motion is affected by chronic ankle instability (CAI) in terms of altered kinematics. This study focuses on multisegmental foot-ankle motion and joint coupling in barefoot and taped CAI patients during the three subphases of stance at running. METHODS Foot segmental motion data of 12 controls and 15 CAI participants during running with a heel strike pattern were collected through gait analysis. CAI participants performed running trials in three conditions: barefoot running, and running with high-dye and low-dye taping. Dependent variables were the range of motion (RoM) occurring at the different inter-segment angles as well as the cross-correlation coefficients between predetermined segments. RESULTS There were no significant RoM differences for barefoot running between CAI patients and controls. In taped conditions, the first two subphases only showed RoM changes at the midfoot without apparent RoM reduction compared to the barefoot CAI condition. In the last subphase there was limited RoM reduction at the mid- and rearfoot. Cross-correlation coefficients highlighted a tendency towards weaker joint coupling in the barefoot CAI condition compared to the controls. Joint coupling within the taped CAI conditions did not show optimization compared to the barefoot CAI condition. CONCLUSIONS RoM was not significantly changed for barefoot running between CAI patients and controls. In taped conditions, there was no distinct tendency towards lower mean RoM values due to the mechanical restraints of taping. Joint coupling in CAI patients was not optimized by taping.
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Felicetti G, Thoumie P, Do MC, Schieppati M. Cutaneous and muscular afferents from the foot and sensory fusion processing: Physiology and pathology in neuropathies. J Peripher Nerv Syst 2021; 26:17-34. [PMID: 33426723 DOI: 10.1111/jns.12429] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 12/16/2022]
Abstract
The foot-sole cutaneous receptors (section 2), their function in stance control (sway minimisation, exploratory role) (2.1), and the modulation of their effects by gait pattern and intended behaviour (2.2) are reviewed. Experimental manipulations (anaesthesia, temperature) (2.3 and 2.4) have shown that information from foot sole has widespread influence on balance. Foot-sole stimulation (2.5) appears to be a promising approach for rehabilitation. Proprioceptive information (3) has a pre-eminent role in balance and gait. Reflex responses to balance perturbations are produced by both leg and foot muscle stretch (3.1) and show complex interactions with skin input at both spinal and supra-spinal levels (3.2), where sensory feedback is modulated by posture, locomotion and vision. Other muscles, notably of neck and trunk, contribute to kinaesthesia and sense of orientation in space (3.3). The effects of age-related decline of afferent input are variable under different foot-contact and visual conditions (3.4). Muscle force diminishes with age and sarcopenia, affecting intrinsic foot muscles relaying relevant feedback (3.5). In neuropathy (4), reduction in cutaneous sensation accompanies the diminished density of viable receptors (4.1). Loss of foot-sole input goes along with large-fibre dysfunction in intrinsic foot muscles. Diabetic patients have an elevated risk of falling, and vision and vestibular compensation strategies may be inadequate (4.2). From Charcot-Marie-Tooth 1A disease (4.3) we have become aware of the role of spindle group II fibres and of the anatomical feet conditions in balance control. Lastly (5) we touch on the effects of nerve stimulation onto cortical and spinal excitability, which may participate in plasticity processes, and on exercise interventions to reduce the impact of neuropathy.
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Affiliation(s)
- Guido Felicetti
- Istituti Clinici Scientifici Maugeri IRCCS, Unit of Neuromotor Rehabilitation, Institute of Montescano, Pavia, Italy
| | - Philippe Thoumie
- Service de rééducation neuro-orthopédique, Hôpital Rothschild APHP, Université Sorbonne, Paris, France.,Agathe Lab ERL Inserm U-1150, Paris, France
| | - Manh-Cuong Do
- Université Paris-Saclay, CIAMS, Orsay, France.,Université d'Orléans, CIAMS, Orléans, France
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44
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Khallaf ME, Fayed E, Sweif RE, Alsalem A. Relationship between dynamic foot-ground contact area and balance impairments in adolescents with down syndrome. J Pediatr Rehabil Med 2021; 14:425-432. [PMID: 34511516 DOI: 10.3233/prm-200764] [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] Open
Abstract
PURPOSE Down Syndrome (DS) is characterized by intellectual disability, hypotonia, and joint laxity. Physical disability can be an additional problem and manifests as reduced lower limb muscle strength and impaired balance. The objectives of this study were to characterize DS dynamic foot-ground contact area and to study its relationship with balance impairment among adolescents with DS. METHODS Twenty-eight children and adolescents with DS and 28 non-DS adolescents/children were matched for age and sex. The Oxford Ankle Foot Questionnaire (parents' version) was used to measure disability related to ankle/foot problems in all subjects. A pressure-sensitive mat was used to assess the contact area and arch index. Also, a Biodex balance system was used for measuring postural stability. RESULTS There were significant differences between both groups in all domains of the Oxford Ankle Foot Questionnaire, overall contact area, and arch index (p < 0.05). Overall postural stability index was significantly decreased in subjects with DS (p < 0.05). There was a nonsignificant correlation between contact area and postural stability (p > 0.05). CONCLUSION Adolescents with DS exhibited larger mid-foot and forefoot contact areas with respect to non-DS matched children. Impairment of balance in adolescents with DS is a multifactorial problem not related to changes in the foot contact area.
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Affiliation(s)
- Mohamed E Khallaf
- Department of Physical Therapy for Neuromuscular Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt.,University of St. Augustine for Health Sciences, Austin, Texas, USA
| | - Eman Fayed
- Department of Physical Therapy for Cardio-Pulmonary Dysfunctions & Geriatrics, Misr University for Science and Technology, 6th of October City, Egypt.,Department of Physical Therapy, College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia
| | - Radwa E Sweif
- Department Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Abdulkarem Alsalem
- Department Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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45
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Postural instability in Parkinson’s disease: Review and bottom-up rehabilitative approaches. Neurophysiol Clin 2020; 50:479-487. [DOI: 10.1016/j.neucli.2020.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/07/2020] [Accepted: 10/23/2020] [Indexed: 11/23/2022] Open
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46
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Potential efficacy of sensorimotor exercise program on pain, proprioception, mobility, and quality of life in diabetic patients with foot burns: A 12-week randomized control study. Burns 2020; 47:587-593. [PMID: 32888746 DOI: 10.1016/j.burns.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/26/2020] [Accepted: 08/05/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Both diabetes mellitus (DM) and burn injuries lead to physical and psychological impairments. Foot burns are still a challenging health condition because of its important sensory role. No previous studies have assessed the physical therapy intervention on diabetic patients with foot burns. Therefore, this study aimed to assess the potential efficacy of sensorimotor exercise on pain, proprioception, mobility, balance, and quality of life in diabetic patients with foot burns. METHODS Between July 2019 and February 2020, thirty-three diabetic patients with foot burns, aged 32 to 46yrs, were enrolled in this randomized control study, and randomized consecutively into two groups, study group (n=16) and control group (n=17). The study group underwent a sensorimotor exercise program thrice a week for 12 consecutive weeks, however the control group did not undergo the exercise intervention. Both groups were instructed to conduct home exercises. Visual analogue scale (VAS), proprioceptive responses, time-up and go (TUG) values, and short form-36 (SF-36) have been assessed prior and subsequent to the study intervention. RESULTS No significant differences were observed between groups regarding baseline data (p˃0.05). Subsequent to 12wk intervention, the study group showed significant improvements in outcome measures (proprioceptive responses, p˂0.05, VAS, p˂0.001, TUG, p=0.003, and SF-36, p˂0.001) and the control group exhibited significant changes in VAS and SF-36 (p=0.004, p=0.043 respectively) however, no significant changes were found in proprioceptive responses and TUG values (p˃0.05). Between groups, the post-intervention comparison demonstrated statistical differences with tending toward the study group (proprioceptive responses, p˂0.05, VAS, p˂0.001, TUG, p=0.013, and SF-36, p=0.046). CONCLUSIONS Sensorimotor exercise training may improve, pain, proprioceptive responses, mobility, balance, and quality of life in diabetic patients with foot burns. Physiotherapists and rehabilitation providers should include the sensorimotor exercise in their protocols in the treatment of diabetic patients with foot burns.
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47
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Viseux FJF, Martins DF, Villeneuve P, Charpentier P, de Sant'Anna E Silva L, Salgado ASI, Lemaire A. Effect of sensory stimulation applied under the great toe on postural ability in patients with fibromyalgia. Somatosens Mot Res 2020; 37:172-179. [PMID: 32419591 DOI: 10.1080/08990220.2020.1765767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Fibromyalgia (FM) is a chronic pain syndrome, characterised by several symptoms. One of the most prevalent symptoms in FM is balance impairment that compromise the autonomy, function and performance status of patients.Purpose: The main objective of the present study was to evaluate the effect of sensory stimulation provided by the use of a low additional thickness of 0.8 mm placed under the great toes bilaterally on the centre of pressure (CoP) measures in patients with FM. It was hypothesised that postural ability would change with a low focal additional thickness used to compute these measures.Materials and Method: Twenty-four patients with FM voluntarily participated in this study. Postural performance during quiet standing was investigated through the CoP displacements recorded using a force-plate. Sensory stimulation was provided by a small additional thickness of 0.8 mm placed under the great toe bilaterally and two conditions were compared: additional thickness 0 (control) and 0.8 mm.Results: An improvement of body balance through spatial parameters with sensory cutaneous stimulation applied under the great toe bilaterally were observed in patients with FM. Our results showed a significant decrease of surface area and mean speed of CoP, associated to a significant decrease of variance of speed. An additional observation is that sagittal (Y) mean position of the CoP gets more anterior (+ 5 mm) relative to control condition.Conclusion: These findings brings new clinical perspectives in the development of intervention strategies in the management of patients with FM and balance disorders, completing validated therapeutic strategies.
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Affiliation(s)
- Frederic J F Viseux
- Laboratoire d'Automatique, de Mécanique et d'Informatique industrielle et Humaine (LAMIH) - UMR CNRS 8201, Université Polytechnique des Hauts-de-France, Valenciennes, France.,Centre d'Evaluation et de Traitement de la Douleur (CETD), Centre hospitalier de Valenciennes, Valenciennes, France.,Posture Lab, Paris, France
| | - Daniel F Martins
- Experimental Neuroscience Laboratory (LaNEx), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoça, Brazil
| | | | - Pascal Charpentier
- Centre d'Evaluation et de Traitement de la Douleur (CETD), Centre hospitalier de Valenciennes, Valenciennes, France
| | | | - Afonso S I Salgado
- Institute of Integral Health, Londrina, Brazil.,Experimental Neuroscience Laboratory (LaNEx), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoça, Brazil
| | - Antoine Lemaire
- Centre d'Evaluation et de Traitement de la Douleur (CETD), Centre hospitalier de Valenciennes, Valenciennes, France
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