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Van den Borre I, Peiffer M, Huysentruyt R, Huyghe M, Vervelghe J, Pizurica A, Audenaert EA, Burssens A. Development and validation of a fully automated tool to quantify 3D foot and ankle alignment using weight-bearing CT. Gait Posture 2024; 113:67-74. [PMID: 38850852 DOI: 10.1016/j.gaitpost.2024.05.029] [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: 12/26/2023] [Revised: 05/08/2024] [Accepted: 05/27/2024] [Indexed: 06/10/2024]
Abstract
INTRODUCTION Foot and ankle alignment plays a pivotal role in human gait and posture. Traditional assessment methods, relying on 2D standing radiographs, present limitations in capturing the dynamic 3D nature of foot alignment during weight-bearing and are prone to observer error. This study aims to integrate weight-bearing CT (WBCT) imaging and advanced deep learning (DL) techniques to automate and enhance quantification of the 3D foot and ankle alignment. METHODS Thirty-two patients who underwent a WBCT of the foot and ankle were retrospectively included. After training and validation of a 3D nnU-Net model on 45 cases to automate the segmentation into bony models, 35 clinically relevant 3D measurements were automatically computed using a custom-made tool. Automated measurements were assessed for accuracy against manual measurements, while the latter were analyzed for inter-observer reliability. RESULTS DL-segmentation results showed a mean dice coefficient of 0.95 and mean Hausdorff distance of 1.41 mm. A good to excellent reliability and mean prediction error of under 2 degrees was found for all angles except the talonavicular coverage angle and distal metatarsal articular angle. CONCLUSION In summary, this study introduces a fully automated framework for quantifying foot and ankle alignment, showcasing reliability comparable to current clinical practice measurements. This operator-friendly and time-efficient tool holds promise for implementation in clinical settings, benefiting both radiologists and surgeons. Future studies are encouraged to assess the tool's impact on streamlining image assessment workflows in a clinical environment.
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Affiliation(s)
- Ide Van den Borre
- Department of Telecommunications and Information Processing, Group for Artificial Intelligence and Sparse Modelling (GAIM), Ghent University, St-Pietersnieuwstraat 41, Gent, OVL B-9000, Belgium
| | - Matthias Peiffer
- Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, Gent, OVL 9000, Belgium; Foot and Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, USA
| | - Roel Huysentruyt
- Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, Gent, OVL 9000, Belgium
| | - Manu Huyghe
- Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, Gent, OVL 9000, Belgium
| | - Jean Vervelghe
- Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, Gent, OVL 9000, Belgium
| | - Aleksandra Pizurica
- Department of Telecommunications and Information Processing, Group for Artificial Intelligence and Sparse Modelling (GAIM), Ghent University, St-Pietersnieuwstraat 41, Gent, OVL B-9000, Belgium
| | - Emmanuel A Audenaert
- Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, Gent, OVL 9000, Belgium
| | - Arne Burssens
- Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, Gent, OVL 9000, Belgium.
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Zhang X, Sun R. Joint synergy and muscle activity in the motion of the ankle-foot complex. J Exp Biol 2024; 227:jeb248069. [PMID: 39034687 DOI: 10.1242/jeb.248069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
The movement of the ankle-foot complex joints is coupled as a result of various physiological and physical constraints. This study introduces a novel approach to the analysis of joint synergies and their physiological basis by focusing on joint rotational directions and the types of muscle contractions. We developed a biomimetic model of the ankle-foot complex with seven degrees of freedom, considering the skeletal configuration and physiological axis directions. Motion capture experiments were conducted with eight participants performing dorsiflexion and plantarflexion in open-chain states, as well as various walking tasks in closed-chain states, across different ground inclinations (±10, ±5, 0 deg) and walking speeds (3 and 4 km h-1). Hierarchical cluster analysis identified joint synergy clusters and motion primitives, revealing that in open-chain movements, plantarflexion of the ankle, tarsometatarsal and metatarsophalangeal joints exhibited synergy with the inversion of the remaining joints in the complex; meanwhile, dorsiflexion was aligned with eversion. During closed-chain movements, the synergies grouping was exchanged in the subtalar, talonavicular and metatarsophalangeal joints. Further analysis showed that in open-chain movements, synergy patterns influenced by multi-joint muscles crossing oblique joint axes contribute to foot motion. In closed-chain movements, these changes in synergistic patterns enhance the propulsion of the center of mass towards the contralateral leg and improve foot arch compliance, facilitating human motion. Our work enhances the understanding of the physiological mechanisms underlying synergistic motion within the ankle-foot complex.
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Affiliation(s)
- Xinyue Zhang
- Institute of Medical Equipment Science and Engineering, State Key Laboratory of Intelligent Manufacturing Equipment and Technology, School of Mechanical Science and Engineering , Huazhong University of Science and Technology, Wuhan, Hubei Province, 430074, China
| | - Ronglei Sun
- Institute of Medical Equipment Science and Engineering, State Key Laboratory of Intelligent Manufacturing Equipment and Technology, School of Mechanical Science and Engineering , Huazhong University of Science and Technology, Wuhan, Hubei Province, 430074, China
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Bruening DA, Petersen SR, Ridge ST. New Perspectives on Foot Segment Forces and Joint Kinetics-Integrating Plantar Shear Stresses and Pressures with Multi-segment Foot Modeling. Ann Biomed Eng 2024; 52:1719-1731. [PMID: 38494465 DOI: 10.1007/s10439-024-03484-2] [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: 11/09/2022] [Accepted: 02/24/2024] [Indexed: 03/19/2024]
Abstract
The role of the many small foot articulations and plantar tissues in gait is not well understood. While kinematic multi-segment foot models have increased our knowledge of foot segmental motions, the integration of kinetics with these models could further advance our understanding of foot mechanics and energetics. However, capturing and effectively utilizing segmental ground reaction forces remains challenging. The purposes of this study were to (1) develop methodology to integrate plantar pressures and shear stresses with a multi-segment foot model, and (2) generate and concisely display key normative data from this combined system. Twenty-six young healthy adults walked barefoot (1.3 m/s) across a pressure/shear sensor with markers matching a published 4-segment foot model. A novel anatomical/geometric template-based masking method was developed that successfully separated regions aligned with model segmentation. Directional shear force plots were created to summarize complex plantar shear distributions, showing opposing shear forces both between and within segments. Segment centers of pressure (CoPs) were shown to be primarily stationary within each segment, suggesting that forward progression in healthy gait arises primarily from redistributing weight across relatively fixed contact points as opposed to CoP movement within a segment. Inverse dynamics-based normative foot joint moments and power were presented in the context of these CoPs to aid in interpretation of tissue stresses. Overall, this work represents a successful integration of motion capture with direct plantar pressure and shear measurements for multi-segment foot kinetics. The presented tools are versatile enough to be used with other models and contexts, while the presented normative database may be useful as a baseline comparison for clinical work in gait energetics and efficiency, balance, and motor control. We hope that this work will aid in the advancement and availability of kinetic MSF modeling, increase our knowledge of foot mechanics, and eventually lead to improved clinical diagnosis, rehabilitation, and treatment.
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Affiliation(s)
- Dustin A Bruening
- Department of Exercise Sciences, Brigham Young University, 120F RB, Provo, UT, 84602, USA.
| | - Spencer R Petersen
- Department of Exercise Sciences, Brigham Young University, 120F RB, Provo, UT, 84602, USA
| | - Sarah T Ridge
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, 06117, USA
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Walker J, Thomas A, Stolycia ML, Wilkins RA, Lunn DE. Acute biomechanical responses to wearing a controlled ankle motion (CAM) Walker boot during walking. Gait Posture 2024; 108:208-214. [PMID: 38118224 DOI: 10.1016/j.gaitpost.2023.12.011] [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: 07/03/2023] [Revised: 12/09/2023] [Accepted: 12/14/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND Controlled ankle motion (CAM) boots are often prescribed during the rehabilitation of lower limb injuries and pathologies to reduce foot and ankle movement and loading whilst allowing the patient to maintain normal daily function. RESEARCH QUESTION The aim of this study was to quantify the compensatory biomechanical mechanisms undergone by the ipsilateral hip and knee joints during walking. In addition, the compensatory mechanisms displayed by the contralateral limb were also considered. METHODS Twelve healthy participants walked on an instrumented treadmill at their preferred walking speed. They underwent kinematic and kinetic analysis during four footwear conditions: normal shoes (NORM), a Malleo Immobil Air Walker on the right leg (OTTO), a Rebound® Air Walker on the right leg with (EVEN) and without (OSS) an Evenup Shoelift™ on the contralateral leg. RESULTS CAM boot wear increased the relative joint contribution to total mechanical work from the ipsilateral hip and knee joints (p < 0.05), which was characterised by increased hip and knee abduction during the swing phase of the gait cycle. EVEN increased the absolute work done and relative contribution of the contralateral limb. CAM boot wear reduced walking speed (p < 0.05), which was partially compensated for during EVEN. SIGNIFICANCE The increased hip abduction in the ipsilateral leg was likely caused by the increase in effective leg length and limb mass, which could lead to secondary site complications following prolonged CAM boot wear. Although prescribing an even-up walker partially mitigates these compensatory mechanisms, adverse effects to contralateral limb kinematics and kinetics (e.g., elevated knee joint work) should be considered.
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Affiliation(s)
- Josh Walker
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom.
| | - Aaron Thomas
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
| | - Mason L Stolycia
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
| | - Richard A Wilkins
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom; Podiatry Department, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - David E Lunn
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
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Sancho-Bru JL, Sanchis-Sales E, Rodríguez-Cervantes PJ, Vergés-Salas C. Foot Sole Contact Forces vs. Ground Contact Forces to Obtain Foot Joint Moments for In-Shoe Gait-A Preliminary Study. SENSORS (BASEL, SWITZERLAND) 2023; 23:6744. [PMID: 37571530 PMCID: PMC10422389 DOI: 10.3390/s23156744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023]
Abstract
In-shoe models are required to extend the clinical application of current multisegment kinetic models of the bare foot to study the effect of foot orthoses. Work to date has only addressed marker placement for reliable kinematic analyses. The purpose of this study is to address the difficulties of recording contact forces with available sensors. Ten participants walked 5 times wearing two different types of footwear by stepping on a pressure platform (ground contact forces) while wearing in-shoe pressure sensors (foot sole contact forces). Pressure data were segmented by considering contact cells' anteroposterior location, and were used to compute 3D moments at foot joints. The mean values and 95% confidence intervals were plotted for each device per shoe condition. The peak values and times of forces and moments were computed per participant and trial under each condition, and were compared using mixed-effect tests. Test-retest reliability was analyzed by means of intraclass correlation coefficients. The curve profiles from both devices were similar, with higher joint moments for the instrumented insoles at the metatarsophalangeal joint (~26%), which were lower at the ankle (~8%) and midtarsal (~15%) joints, although the differences were nonsignificant. Not considering frictional forces resulted in ~20% lower peaks at the ankle moments compared to previous studies, which employed force plates. The device affected both shoe conditions in the same way, which suggests the interchangeability of measuring joint moments with one or the other device. This hypothesis was reinforced by the intraclass correlation coefficients, which were higher for the peak values, although only moderate-to-good. In short, both considered alternatives have drawbacks. Only the instrumented in-soles provided direct information about foot contact forces, but it was incomplete (evidenced by the difference in ankle moments between devices). However, recording ground reaction forces offers the advantage of enabling the consideration of contact friction forces (using force plates in series, or combining a pressure platform and a force plate to estimate friction forces and torque), which are less invasive than instrumented insoles (which may affect subjects' gait).
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Affiliation(s)
- Joaquín L. Sancho-Bru
- Department of Mechanical Engineering and Construction, Universitat Jaume I, 12071 Castellón de la Plana, Spain;
| | - Enrique Sanchis-Sales
- Departmental Section of Podiatry, Nursing Department, Universitat de València, 46010 Valencia, Spain;
| | | | - Carles Vergés-Salas
- Departmental Section of Podiatry, Department of Clinical Sciences, Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08907 L’Hospitalet de Llobregat, Spain;
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Rodrigues R, Gonçalves V, Casagrande R, Cemin F, Nodari C, Borges I, Fitarelli L, Bianchesse J, Rocha ESD, Rabello R. Are proximal and distal neuromuscular parameters able to predict hip and knee frontal plane kinematics during single-leg landing? Phys Ther Sport 2023; 59:30-36. [PMID: 36481454 DOI: 10.1016/j.ptsp.2022.11.007] [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: 08/28/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE To determine if proximal and distal neuromuscular parameters (EMG amplitude and median frequency - MDF) can predict frontal plane kinematics during single-leg landing. STUDY DESIGN Cross sectional study. SETTING Laboratory. PARTICIPANTS Fifteen participants (7 female) performed six single-leg landings with measures of frontal plane kinematics and EMG obtained 230 ms after first foot contact, totalizing 90 landings. MAIN OUTCOME MEASURES (i) 2D hip adduction [hip ADD] and knee frontal plane projection angle [knee FPPA]; (ii) EMG amplitude and MDF of gluteus medius [GMed], tensor fascia latae [TFL], peroneus longus [PL] and tibialis anterior [TA]. RESULTS We observed that MDF of TA was a significant predictor of hip ADD (p = 0.037; β = -0.049 Hz; R2c = 0.30). Also, MDF of PL was significant predictor of knee FPPA (p = 0.043; β = 0.042 Hz; R2c = 0.37). Hip muscles and EMG amplitude parameters were not considered predictors of frontal plane kinematics. CONCLUSION The firing frequency of ankle muscles predicted the variance of hip and knee frontal plane kinematics during single-leg landing.
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Affiliation(s)
- Rodrigo Rodrigues
- Institute of Education, Federal University of Rio Grande, Rio Grande, RS, Brazil.
| | - Vagner Gonçalves
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil
| | - Rafael Casagrande
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil
| | - Fabrício Cemin
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil
| | - Camila Nodari
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil
| | - Iury Borges
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil
| | - Luan Fitarelli
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil
| | - Jean Bianchesse
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil
| | - Emmanuel Souza da Rocha
- Department of Physical Therapy, Integrated Colleges of Taquara, Taquara, RS, Brazil; Physical Activity, Sport and Health Research Group, Department of Physical Therapy, Sogipa Faculty, Porto Alegre, RS, Brazil
| | - Rodrigo Rabello
- Department of Biomedical Sciences for Health, University of Milan, Milan, MI, Italy
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The role of hip abductor strength and ankle dorsiflexion range of motion on proximal, local and distal muscle activation during single-leg squat in patellofemoral pain women: an all-encompassing lower limb approach. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00980-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Foot contact forces can be used to personalize a wearable robot during human walking. Sci Rep 2022; 12:10947. [PMID: 35768457 PMCID: PMC9243054 DOI: 10.1038/s41598-022-14776-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/13/2022] [Indexed: 11/09/2022] Open
Abstract
Individuals with below-knee amputation (BKA) experience increased physical effort when walking, and the use of a robotic ankle-foot prosthesis (AFP) can reduce such effort. The walking effort could be further reduced if the robot is personalized to the wearer using human-in-the-loop (HIL) optimization of wearable robot parameters. The conventional physiological measurement, however, requires a long estimation time, hampering real-time optimization due to the limited experimental time budget. This study hypothesized that a function of foot contact force, the symmetric foot force-time integral (FFTI), could be used as a cost function for HIL optimization to rapidly estimate the physical effort of walking. We found that the new cost function presents a reasonable correlation with measured metabolic cost. When we employed the new cost function in HIL ankle-foot prosthesis stiffness parameter optimization, 8 individuals with simulated amputation reduced their metabolic cost of walking, greater than 15% (p < 0.02), compared to the weight-based and control-off conditions. The symmetry cost using the FFTI percentage was lower for the optimal condition, compared to all other conditions (p < 0.05). This study suggests that foot force-time integral symmetry using foot pressure sensors can be used as a cost function when optimizing a wearable robot parameter.
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Contributions of Intrinsic and Extrinsic Foot Muscles during Functional Standing Postures. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7708077. [PMID: 35572731 PMCID: PMC9098302 DOI: 10.1155/2022/7708077] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/23/2022] [Accepted: 04/11/2022] [Indexed: 12/29/2022]
Abstract
Purpose. Maintaining balance during static standing postures requires the coordination of many neuromuscular mechanisms. The role of the intrinsic and extrinsic foot muscles in this paradigm has yet to be clearly defined. The purpose of this study was to explore foot muscle activation during static phases on common weight-bearing tasks of varying loads and balance demands. Methods. Twenty healthy young adults performed 6 standing postures (single-limb and double-limb stand, squat, and heel raise) with one foot on a force plate. Muscle activity was recorded from the abductor hallucis, flexor hallucis longus and brevis, and tibialis posterior using intramuscular electrodes; surface electrodes were used to record activity from the peroneus longus and tibialis anterior. Two-way repeated measures ANOVA (2 loading conditions × 3 postures) were run to compare muscle activation and center of pressure velocity. Results. Intrinsic foot muscle activity increased as loading and postural demand increased; however, the specific effects varied for each of the extrinsic foot muscles. Conclusions. These results suggest that the intrinsic foot muscles play an important role in maintaining static balance. Strengthening intrinsic and extrinsic foot muscles may help increase stability in people who have weak toe flexors or who suffer from a variety of foot pathologies.
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Rodrigues R, Daiana Klein K, Dalcero Pompeo K, Aurélio Vaz M. Are There Neuromuscular Differences on Proximal and Distal Joints in Patellofemoral Pain People? A Systematic Review and Meta-Analysis. J Electromyogr Kinesiol 2022; 64:102657. [DOI: 10.1016/j.jelekin.2022.102657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 02/11/2022] [Accepted: 03/16/2022] [Indexed: 12/26/2022] Open
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Xie K, Lyu Y, Zhang X, Song R. How Compliance of Surfaces Affects Ankle Moment and Stiffness Regulation During Walking. Front Bioeng Biotechnol 2021; 9:726051. [PMID: 34676201 PMCID: PMC8523823 DOI: 10.3389/fbioe.2021.726051] [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: 06/16/2021] [Accepted: 08/10/2021] [Indexed: 11/21/2022] Open
Abstract
Humans can regulate ankle moment and stiffness to cope with various surfaces during walking, while the effect of surfaces compliance on ankle moment and stiffness regulations remains unclear. In order to find the underlying mechanism, ten healthy subjects were recruited to walk across surfaces with different levels of compliance. Electromyography (EMG), ground reaction forces (GRFs), and three-dimensional reflective marker trajectories were recorded synchronously. Ankle moment and stiffness were estimated using an EMG-driven musculoskeletal model. Our results showed that the compliance of surfaces can affect both ankle moment and stiffness regulations during walking. When the compliance of surfaces increased, the ankle moment increased to prevent lower limb collapse and the ankle stiffness increased to maintain stability during the mid-stance phase of gait. Our work improved the understanding of gait biomechanics and might be instructive to sports surface design and passive multibody model development.
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Affiliation(s)
- Kaifan Xie
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Engineering and Technology Center of Advanced and Portable Medical Devices, Sun Yat-sen University, Guangzhou, China
| | - Yueling Lyu
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Engineering and Technology Center of Advanced and Portable Medical Devices, Sun Yat-sen University, Guangzhou, China
| | - Xianyi Zhang
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Engineering and Technology Center of Advanced and Portable Medical Devices, Sun Yat-sen University, Guangzhou, China
| | - Rong Song
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Engineering and Technology Center of Advanced and Portable Medical Devices, Sun Yat-sen University, Guangzhou, China
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Bartolo E, Giacomozzi C, Coppini DV, Gatt A. The effect of induced joint restriction on plantar pressure during gait - a pilot study. Gait Posture 2021; 90:23-28. [PMID: 34365284 DOI: 10.1016/j.gaitpost.2021.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/14/2021] [Accepted: 07/24/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The aim of this study was to analyse the effect of induced lower limb joint restriction on plantar pressures during gait. Focusing on restricting a single joint, without the effect of other co-morbidities, would provide better understanding as to the resultant plantar loadings during gait, which would be especially beneficial in patients requiring offloading procedures. RESEARCH QUESTION Does induced lower limb joint restriction affect plantar pressure distribution during gait? METHODS A prospective, quasi-experimental study was conducted, recruiting ten healthy, adult participants who were instructed to walk barefoot over a Tekscan HR Mat™. This procedure was repeated after separately inducing restriction of the hip, knee and ankle joints. Mean peak plantar pressure (MPP) and pressure-time integral (PTI) data were analysed to compare between unrestricted and restricted data. RESULTS Significant plantar pressure changes were observed in the heel and first metatarsal regions. Rearfoot PTIs were increased with restriction of the contralateral hip (left p <0.001) (right p =0.02) and knee joints (left p =0.01) (right p =0.04). Both MPPs (left p =0.01; right p =0.01) and PTIs (left p =0.004; right p =0.03) were increased in the first metatarsal when restricting the hip joint of the same limb. MPP was decreased in the left first metatarsal with induced knee (left p =0.01; right p =0.04) and ankle (left and right p <0.001) joint restriction. Finally, MPP was decreased in the right first metatarsal with knee (left and right p =0.01) and ankle (left p =0.04; right p =0.01) joint restriction. SIGNIFICANCE Limited joint mobility may have a direct effect on plantar pressure, particularly with restriction in the hip and knee joints, hence careful attention should be given especially in patients with conditions involving plantar loadings. Results in this study also show that PTI changes during gait should be equally evaluated clinically along with peak plantar pressure analysis.
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Affiliation(s)
- Erica Bartolo
- Faculty of Health Sciences, University of Malta, Msida, Malta.
| | - Claudia Giacomozzi
- Department of Cardiovascular Diseases, Dysmetabolic Diseases & Ageing, Italian National Institute of Health, Rome, Italy.
| | | | - Alfred Gatt
- Faculty of Health Sciences, University of Malta, Msida, Malta.
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Choi S, Shin G. Effect of medial foot loading self-practice on lower limb kinematics in young individuals with asymptomatic varus knee alignment. Knee 2021; 30:305-313. [PMID: 34015587 DOI: 10.1016/j.knee.2021.04.018] [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: 08/27/2020] [Revised: 03/22/2021] [Accepted: 04/21/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Varus alignment of the knee is a risk factor for developing knee osteoarthritis. Recently, voluntary shifting the plantar pressure distribution medially (medial foot loading) during gait has been found to reduce knee adduction angle during stance, which may lower the joint load. However, it is not yet known whether such effect would persist after long-term self-practice. This study aimed to determine whether medial foot loading can be an effective self-care protocol for reducing the knee adduction angle. METHODS Eight subjects with asymptomatic varus knee alignment were trained on medial foot loading once in a laboratory, then carried out as self-practice for 8 weeks outside the laboratory. Spatiotemporal gait parameters and lower limb joint kinematics data were collected during natural walking prior to the training (baseline walking), during the practice session immediately after the initial training (trained walking), and during natural walking after the self-practice period (post-practice walking). RESULTS Participants walked significantly faster after the self-practice period with longer step length compared with the baseline. The knee adduction angle at initial contact, maximum angle during stance, and mean angle during a gait cycle were significantly decreased during both the trained and post-practice walking compared with baseline. The 8-week self-practice caused larger decrements in the three angles than the single training, but no significant differences were found between the two conditions. CONCLUSIONS Self-practice of medial foot loading walking could be an effective gait strategy to reduce the knee adduction angle. The effect could be sustained for individuals with asymptomatic varus knee alignment.
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Affiliation(s)
- Seobin Choi
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - Gwanseob Shin
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea.
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Kalaycioglu T, Apostolopoulos NC, Yurt Y, Tunay VB. The effectiveness of different ankle strengthening training programs on performance. J Sports Med Phys Fitness 2021; 62:435-447. [PMID: 33768775 DOI: 10.23736/s0022-4707.21.12130-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to investigate the effectiveness of different ankle strengthening training programs: eccentric, concentric, and resistance bands, on performance of university level sedentary males. METHODS Sixty-three males between the ages of 18 and 26 years were randomized to either eccentric isokinetic (n=21), concentric isokinetic (n=21), and resistance bands ankle strengthening groups (n=21). Training was performed three days a week, for eight weeks for both sides of ankle. Each program was made progressively harder by increasing the number of repetitions or sets. Measurements evaluating strength, balance and jumping performance were repeated pre, post and at one month (follow-up) after training. RESULTS Statistical significance was observed for concentric evertor strength for both sides of the ankle for all groups after training (p<0.05). In addition, statistically significant increases were seen in jumping performance for all groups and dynamic balance for eccentric and concentric groups (p<0.05), with the concentric being statistically higher compared to the resistance bands group for all parameters (p<0.05). CONCLUSIONS Ankle isokinetic strength (eccentric, concentric) training is more effective than resistance bands regarding improvement on strength, explosive strength, and dynamic balance. Ankle isokinetic strength training, which includes evertor and invertor muscles, improves performance, especially when applied concentrically. Therefore, the proper strengthening of ankle muscles will prevent the re-injury of ankles with individuals returning to activities.
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Affiliation(s)
- Tugce Kalaycioglu
- Department of Physiotherapy and Rehabilitation, School of Health Sciences, Cyprus Health and Social Sciences University, Morphou, North Cyprus via Mersin, Turkey -
| | - Nikos C Apostolopoulos
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Yasin Yurt
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, North Cyprus via Mersin, Turkey
| | - Volga B Tunay
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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15
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Magalhães FA, Fonseca ST, Araújo VL, Trede RG, Oliveira LM, Castor CGME, Pinto RZ, Souza TR. Midfoot passive stiffness affects foot and ankle kinematics and kinetics during the propulsive phase of walking. J Biomech 2021; 119:110328. [PMID: 33611052 DOI: 10.1016/j.jbiomech.2021.110328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/11/2020] [Accepted: 02/07/2021] [Indexed: 11/18/2022]
Abstract
The midfoot joint complex (MFJC) is related to the mechanics and efficiency of the walking propulsive phase and low midfoot passive stiffness may require compensatory foot and ankle joint moments to avoid excessive pronation and inefficient propulsion. This study aimed to investigate the kinematics and kinetics of the MFJC and ankle during the propulsive phase of walking in subjects with larger and smaller midfoot passive stiffness. MFJC passive stiffness of 20 healthy adult participants, and the kinematics and kinetics of the MFJC (forefoot-rearfoot) and ankle (rearfoot-shank) during the stance phase of walking were measured. The participants were divided equally into two groups according to the MFJC passive stiffness. Ranges of motion (ROM) and mean joint moments were computed for the late stance. Independent t-tests (α = 0.05) revealed that subjects with lower midfoot passive stiffness showed an increased MFJC sagittal ROM (flattened longitudinal arch) (p = 0.002), increased ankle frontal ROM (more everted positions) (p = 0.002), increased MFJC frontal ROM (more inverted positions) (p = 0.019), as well as a tendency for larger ankle sagittal ROM (p = 0.056). They also showed increased MFJC (p = 0.021) and ankle (p = 0.018) moments in the sagittal plane, increased MFJC moment in the frontal plane (p = 0.047) and a tendency for a predominant ankle moment in the frontal (p = 0.058). Foot and ankle joint moments are possible strategies to reduce pronation and improve propulsion, but not sufficient to prevent the altered kinematics related to low midfoot stiffness. Therefore, midfoot passive stiffness is critical for foot and ankle kinematics and kinetics during walking propulsive phase and is a potential target of interventions.
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Affiliation(s)
- Fabrício Anicio Magalhães
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences; Belo Horizonte, Minas Gerais, Brazil
| | - Sérgio Teixeira Fonseca
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences; Belo Horizonte, Minas Gerais, Brazil
| | - Vanessa Lara Araújo
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences; Belo Horizonte, Minas Gerais, Brazil
| | - Renato Guilherme Trede
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Department of Physical Therapy, Graduate Program in Rehabilitation and Functional Performance, Diamantina, Minas Gerais, Brazil
| | - Lílian Marques Oliveira
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences; Belo Horizonte, Minas Gerais, Brazil
| | - Camila Gomes Miranda E Castor
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences; Belo Horizonte, Minas Gerais, Brazil
| | - Rafael Zambelli Pinto
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences; Belo Horizonte, Minas Gerais, Brazil
| | - Thales Rezende Souza
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences; Belo Horizonte, Minas Gerais, Brazil.
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16
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Wang W, Wei H, Shi R, Lin L, Zhang L, Yue S, Zhao Q, Jia X, Li K, Zhang Y. Dysfunctional muscle activities and co-contraction in the lower-limb of lumbar disc herniation patients during walking. Sci Rep 2020; 10:20432. [PMID: 33235289 PMCID: PMC7686363 DOI: 10.1038/s41598-020-77150-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/06/2020] [Indexed: 11/19/2022] Open
Abstract
This study aimed to investigate lower-limb muscle activities in gait phases and co-contraction of one gait cycle in patients with lumbar disc herniation (LDH). This study enrolled 17 LDH patients and 17 sex- and age-matched healthy individuals. Bilateral muscle activities of the rectus femoris (RF), biceps femoris long head (BL), tibialis anterior (TA), and lateral gastrocnemius (LG) during walking were recorded. The gait cycle was divided into four phases by the heel strike and top off according to the kinematics tracks. Root mean square (RMS), mean frequency (MF), and co-contraction of surface electromyography signals were calculated. The LDH patients showed enhanced BL RMS during the single support phase (SS), second double support phase, and swing phase (SW) as well as decreased MF of RF during SS and of TA and LG during SW (p < 0.05). The co-contraction of the TA-LG was increased in LDH patients than in the control group (p < 0.05). Positive correlations were observed between TA-LG co-contraction (affected side, r = 0.557, p = 0.020; contralateral side, r = 0.627, p = 0.007) and the Oswestry disability index scores in LDH patients. LDH patients have increased BL firing rate and insufficient motor unit recruitment in specific phases in the lower limbs during walking. Dysfunction in LDH patients was associated with immoderate intermuscular co-contraction of the TA-LG during walking.
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Affiliation(s)
- Wei Wang
- Department of Physical Medicine and Rehabilitation, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China
| | - Hui Wei
- Department of Physical Medicine and Rehabilitation, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China
| | - Runxiu Shi
- Department of Physical Medicine and Rehabilitation, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China
| | - Leitong Lin
- Laboratory of Motor Control and Rehabilitation, Institute of Biomedical Engineering, School of Control Science and Engineering, Shandong University, 17923 Jingshi Aveue, Jinan, 250061, Shandong, China
| | - Lechi Zhang
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Shouwei Yue
- Department of Physical Medicine and Rehabilitation, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China
| | - Qin Zhao
- Department of Physical Medicine and Rehabilitation, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China
| | - Xiaofeng Jia
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.,Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.,Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.,Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.,Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Ke Li
- Laboratory of Motor Control and Rehabilitation, Institute of Biomedical Engineering, School of Control Science and Engineering, Shandong University, 17923 Jingshi Aveue, Jinan, 250061, Shandong, China.
| | - Yang Zhang
- Department of Physical Medicine and Rehabilitation, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China.
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17
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Rodrigues R, Souza da Rocha E, Klein KD, Sonda FC, Pompeo KD, Frasson VB, Vaz MA. Proximal and distal muscle thickness is different in women with patellofemoral pain but is not associated with knee frontal plane projection angle. J Bodyw Mov Ther 2020; 25:205-211. [PMID: 33714497 DOI: 10.1016/j.jbmt.2020.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 09/21/2020] [Accepted: 10/05/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The aim of this study was to compare proximal and distal muscle thickness between patellofemoral pain (PFP) and asymptomatic women (CG) and to verify the possible association between morphology and lower limb alignment during single leg-squat. METHODS Thirty women (PFP, n = 15 and CG, n = 15) performed the following evaluations: (i) muscle thickness of external oblique (EO), gluteus medius (GMed), tensor fascia latae (TFL), peroneus (PER) and tibialis anterior (TA); (ii) knee frontal plane projection angle (FPPA) during single-leg squat. RESULTS Compared with the CG, PFP showed: (1) smaller GMed (-10.02%; p = 0.04; effect size = 0.82), greater TFL (+18.44%; p = 0.02; effect size = 0.92) and PER (+14.23%; p = 0.02; effect size = 0.87) muscle thickness and greater knee FPPA during single-leg squat (+31.8%; p = 0.04; effect size = 1.12). No differences were observed in EO (+7.17%; p = 0.37; effect size = 0.34) and TA (-1.35%; p = 0.81; effect size = 0.12) muscle thickness. Additionally, we failed to observe significant associations between muscle morphology and knee FPPA in both groups. CONCLUSION PFP patients showed alterations in proximal and distal muscle thickness, despite the lack of association with poor lower limb alignment. Prospective studies are necessary to determine if differences in muscle morphology are the cause or the consequence of PFP and to confirm the absence of relationship with lower limb alignment.
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Affiliation(s)
- Rodrigo Rodrigues
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil; Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Emmanuel Souza da Rocha
- Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Kelli Daiana Klein
- Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Francesca Chaida Sonda
- Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Klauber Dalcero Pompeo
- Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Marco Aurélio Vaz
- Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Physique Physiotherapy Centre, Porto Alegre, RS, Brazil
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18
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Kim M, Lyness H, Chen T, Collins SH. The Effects of Prosthesis Inversion/Eversion Stiffness on Balance-Related Variability During Level Walking: A Pilot Study. J Biomech Eng 2020; 142:091011. [PMID: 32280955 DOI: 10.1115/1.4046881] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Indexed: 11/08/2022]
Abstract
Prosthesis features that enhance balance are desirable to people with transtibial amputation. Ankle inversion/eversion compliance is intended to improve balance on uneven ground, but its effects remain unclear on level ground. We posited that increasing ankle inversion/eversion stiffness during level-ground walking would reduce balance-related effort by assisting in recovery from small disturbances in frontal-plane motions. We performed a pilot test with an ankle-foot prosthesis emulator programmed to apply inversion/eversion torques in proportion to the deviation from a nominal inversion/eversion position trajectory. We applied a range of stiffnesses to clearly understand the effect of the stiffness on balance-related effort, hypothesizing that positive stiffness would reduce effort while negative stiffness would increase effort. Nominal joint angle trajectories were calculated online as a moving average over several steps. In experiments with K3 ambulators with unilateral transtibial amputation (N = 5), stiffness affected step-width variability, average step width, margin of stability, intact-foot center of pressure variability, and user satisfaction (p ≤ 0.05, Friedman's test), but not intact-limb evertor average, intact-limb evertor variability, and metabolic rate (p ≥ 0.38, Friedman's test). Compared to zero stiffness, high positive stiffness reduced step-width variability by 13%, step width by 3%, margin of stability by 3%, and intact-foot center of pressure variability by 14%, whereas high negative stiffness had opposite effects and decreased satisfaction by 63%. The results of this pilot study suggest that positive ankle inversion stiffness can reduce active control requirements during level walking.
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Affiliation(s)
- Myunghee Kim
- Department of Mechanical and Industrial Engineering, University of Illinois at Chicago, Chicago, IL 60607
| | - Hannah Lyness
- Robotics Institute, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Tianjian Chen
- Department of Mechanical Engineering, Columbia University, New York, NY 10027
| | - Steven H Collins
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305
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19
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Wang D, Wang W, Guo Q, Shi G, Zhu G, Wang X, Liu A. Design and validation of a foot-ankle dynamic simulator with a 6-degree-of-freedom parallel mechanism. Proc Inst Mech Eng H 2020; 234:1070-1082. [PMID: 32650700 DOI: 10.1177/0954411920938902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An in vitro simulation test using a designed well-targeted test rig has been regarded as an effective way to understand the kinematics and dynamics of the foot and ankle complex in the dynamic stance phase, and it also allows alterations in both internal and external control compared to in vivo tests. However, current simulators are limited by some assumptions. In this study, a novel foot and ankle bionic dynamic simulator was developed and validated. A movable 6-degree-of-freedom parallel mechanism, known as Steward platform, was used as the core structure to drive the tibia, with a tibial force actuator applied with different loads. Four major muscle groups were actuated by four sensored pulling cables connected to muscle tendons. Simulation processes were controlled using a software developed based on a proportional-integral-derivative control loop, with tension-compression sensors mounted on tendon pulling cables and used as real-time monitor signals. An iterative learning module for tibial force control was integrated into the control software. Six specimens of the cadaveric foot-ankle were used to validate the simulator. The stance phase was successfully simulated within 5 s, and the tibia loads were applied based on the body weight of the cadaveric specimen donors. Typical three-dimensional ground reaction forces were successfully reproduced. The coefficient of multiple correlation analysis demonstrated good repeatability of the dynamic simulator for the ground reaction force (coefficient of multiple correlation > 0.89) and the range of ankle motion (coefficient of multiple correlation > 0.87 with only one exception). The simulated ranges of the foot-ankle joint rotation in stance were consistent with in vivo measurements, indicating the success of the dynamic simulation process. The proposed dynamic simulator can enhance the understanding of the mechanism of the foot-ankle movement, related injury prevention, and surgical intervention.
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Affiliation(s)
- Dongmei Wang
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Wang
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Qinyang Guo
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Guanglin Shi
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Genrui Zhu
- Huashan Hospital, Fudan University, Shanghai, China
| | - Xu Wang
- Huashan Hospital, Fudan University, Shanghai, China
| | - Anmin Liu
- Centre for Health Sciences Research, University of Salford, Salford, UK
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20
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Araújo VL, Santos TRT, Khuu A, Lewis CL, Souza TR, Holt KG, Fonseca ST. The effects of small and large varus alignment of the foot-ankle complex on lower limb kinematics and kinetics during walking: A cross-sectional study. Musculoskelet Sci Pract 2020; 47:102149. [PMID: 32174545 PMCID: PMC7266625 DOI: 10.1016/j.msksp.2020.102149] [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: 09/10/2019] [Revised: 02/09/2020] [Accepted: 03/05/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The alignment of the foot-ankle complex may influence the kinematics and kinetics of the entire lower limb during walking. OBJECTIVES This study investigated the effect of different magnitudes of varus alignment of the foot-ankle complex (small versus large) on the kinematics and kinetics of foot, ankle, knee, and hip in the frontal and transverse planes during walking. DESIGN Cross-sectional study. METHOD Foot-ankle complex alignment in the frontal plane was measured as the angle between the metatarsal heads and the inferior edge of the examination table, measured with the volunteer in prone maintaining the ankle at 0° in the sagittal plane. The participants (n = 28) were divided into two groups according to their alignment angles. The first group had values equal to or inferior to the 45 percentile, and the second group had values equal to or above the 55 percentile. The lower limb kinematics and kinetics were evaluated with the participant walking at self-select speed in an instrumented treadmill. RESULTS The group of large varus alignment showed significantly higher (p < 0.03) forefoot inversion angle at initial contact, amplitude of rearfoot-shank eversion, and peak of inversion ankle moment. There were no differences (p > 0.05) between the groups for knee and hip amplitudes and moments in the frontal and transverse planes. The durations of rearfoot-shank eversion, knee abduction, knee medial rotation, hip adduction, and hip medial rotation were not different between groups (p > 0.05). CONCLUSION Large varus alignment of the foot-ankle complex may increase the magnitude of foot pronation and ankle inversion moment during walking.
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Affiliation(s)
- Vanessa L. Araújo
- Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil,Author to whom written correspondence should be mailed: Graduate Program in Rehabilitation Science, Department of Physical Therapy, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627 Campus Pampulha, CEP 31270-901, Belo Horizonte, MG, Brazil, , Phone: +55 31 3409 4783, Fax: +55 31 3409 4781
| | - Thiago R. T. Santos
- Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Anne Khuu
- Department of Physical Therapy and Athletic Training, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
| | - Cara L. Lewis
- Department of Physical Therapy and Athletic Training, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
| | - Thales R. Souza
- Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Kenneth G. Holt
- Department of Physical Therapy and Athletic Training, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
| | - Sergio T. Fonseca
- Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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21
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Mujukian A, Ho NC, Day MJ, Ebramzadeh E, Sangiorgio SN. A Systematic Review of Unsystematic Total Ankle Replacement Wear Evaluations. JBJS Rev 2020; 8:e0091. [PMID: 32149932 DOI: 10.2106/jbjs.rvw.19.00091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Numerous studies have reported the use of laboratory multistation joint simulators to successfully predict wear performance and functionality of hip and knee replacements. In contrast, few studies in the peer-reviewed literature have used joint simulation to quantify the wear performance and functionality of ankle replacements. We performed a systematic review of the literature on joint simulator studies that quantified polyethylene wear in total ankle arthroplasty. In addition to the quantified wear results, the load and motion parameters were identified and compared among the studies. METHODS A search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify articles reporting total ankle replacement polyethylene wear using joint simulators. RESULTS Nine studies that used joint simulators and 1 study that used a computer simulation were found. Although all studies used physiological multidirectional motions (i.e., internal/external rotation, plantar flexion/dorsiflexion, anterior/posterior translation), there was large variability among the studies in the magnitudes of these motions. Among these studies, mean non-cross-linked polyethylene wear ranged from 3.3 ± 0.4 to 25.8 ± 3.1 mm per million cycles. In contrast, mean highly cross-linked polyethylene wear ranged from 2.1 ± 0.3 to 3.3 ± 0.4 mm per million cycles. The wide distribution in wear rates was attributable to the highly inconsistent kinematic parameters and loads applied as well as differences in implant design and materials. CONCLUSIONS There is a severe lack of clinically applicable data on wear performance of total ankle replacements in the peer-reviewed literature. No universal set of kinematic load parameters has been established. Furthermore, only 2 of the published studies have validated their findings using independently derived data, such as retrieval analysis. These shortcomings make it difficult to compare findings as a function of design parameters and materials, or to draw clinically relevant conclusions from these simulations. More work is required to enhance the predictive capability of in vitro simulations of total ankle replacements. CLINICAL RELEVANCE The results of joint wear simulator studies may not accurately represent in vivo wear of total ankle replacements. Joint simulator studies should establish that they are accurately replicating in vivo wear, thus enabling use of their predictive capabilities for new materials and designs.
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Affiliation(s)
- Angela Mujukian
- J. Vernon Luck Sr., MD, Orthopaedic Research Center (JVL) at the Orthopaedic Institute for Children (OIC), in alliance with UCLA, Los Angeles, California
| | - Nathan C Ho
- J. Vernon Luck Sr., MD, Orthopaedic Research Center (JVL) at the Orthopaedic Institute for Children (OIC), in alliance with UCLA, Los Angeles, California.,University of Southern California, Los Angeles, California
| | - Matthew J Day
- J. Vernon Luck Sr., MD, Orthopaedic Research Center (JVL) at the Orthopaedic Institute for Children (OIC), in alliance with UCLA, Los Angeles, California
| | - Edward Ebramzadeh
- J. Vernon Luck Sr., MD, Orthopaedic Research Center (JVL) at the Orthopaedic Institute for Children (OIC), in alliance with UCLA, Los Angeles, California
| | - Sophia N Sangiorgio
- J. Vernon Luck Sr., MD, Orthopaedic Research Center (JVL) at the Orthopaedic Institute for Children (OIC), in alliance with UCLA, Los Angeles, California
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22
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Phan CB, Shin G, Lee KM, Koo S. Skeletal kinematics of the midtarsal joint during walking: Midtarsal joint locking revisited. J Biomech 2019; 95:109287. [PMID: 31431345 DOI: 10.1016/j.jbiomech.2019.07.031] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/29/2019] [Accepted: 07/29/2019] [Indexed: 11/29/2022]
Abstract
The kinematics of the human foot complex have been investigated to understand the weight bearing mechanism of the foot. This study aims to investigate midtarsal joint locking during walking by noninvasively measuring the movements of foot bones using a high-speed bi-planar fluoroscopic system. Eighteen healthy subjects volunteered for the study; the subjects underwent computed tomography imaging and bi-planar radiographs of the foot in order to measure the three-dimensional (3D) midtarsal joint kinematics using a 2D-to-3D registration method and anatomical coordinate system in each bone. The relative movements on bone surfaces were also calculated in the talonavicular and calcaneocuboid joints and quantified as surface relative velocity vectors on articular surfaces to understand the kinematic interactions in the midtarsal joint. The midtarsal joint performed a coupled motion in the early stance to pronate the foot to extreme pose in the range of motion during walking and maintained this pose during the mid-stance. In the terminal stance, the talonavicular joint performed plantar-flexion, inversion, and internal rotation while the calcaneocuboid joint performed mainly inversion. The midtarsal joint moved towards an extreme supinated pose, rather than a minimum motion in the terminal stance. The study provides a new perspective to understand the kinematics and kinetics of the movement of foot bones and so-called midtarsal joint locking, during walking. The midtarsal joint continuously moved towards extreme poses together with the activation of muscle forces, which would support the foot for more effective force transfer during push-off in the terminal stance.
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Affiliation(s)
- Cong-Bo Phan
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Geonhui Shin
- School of Mechanical Engineering, Chung-Ang University, Seoul, Republic of Korea
| | - Kyoung Min Lee
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seungbum Koo
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea.
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23
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Zhang X, Pauel R, Deschamps K, Jonkers I, Vanwanseele B. Differences in foot muscle morphology and foot kinematics between symptomatic and asymptomatic pronated feet. Scand J Med Sci Sports 2019; 29:1766-1773. [DOI: 10.1111/sms.13512] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/23/2019] [Accepted: 06/26/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Xianyi Zhang
- Department of Movement Sciences, Human Movement Biomechanics Research Group KU Leuven Leuven Belgium
| | - Rinus Pauel
- Department of Movement Sciences, Human Movement Biomechanics Research Group KU Leuven Leuven Belgium
| | - Kevin Deschamps
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group KU Leuven Leuven Belgium
- Laboratory for Clinical Motion Analysis University Hospital Pellenberg, KU Leuven Leuven Belgium
| | - Ilse Jonkers
- Department of Movement Sciences, Human Movement Biomechanics Research Group KU Leuven Leuven Belgium
| | - Benedicte Vanwanseele
- Department of Movement Sciences, Human Movement Biomechanics Research Group KU Leuven Leuven Belgium
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24
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van Hoeve S, Poeze M. Multisegment Foot Models and Clinical Application After Foot and Ankle Trauma: A Review. J Foot Ankle Surg 2019; 58:748-754. [PMID: 31010768 DOI: 10.1053/j.jfas.2018.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Indexed: 02/03/2023]
Abstract
Since the end of the 1990s, several multisegment foot models (MSFMs) have been developed. Several models were used to describe foot and ankle kinematics in patients with foot and ankle pathologies; however, the diagnostic value for clinical practice of these models is not known. This review searched in the literature for studies describing kinematics in patients after foot and ankle trauma using an MSFM. The diagnostic value of the MSFMs in patients after foot and ankle trauma was also investigated. A search was performed on the databases PubMed/MEDLINE, Embase, and Cochrane Library. To investigate the diagnostic value of MSFMs in patients after foot and ankle trauma, studies were classified and analyzed following the diagnostic research questions formulated by Knottnerus and Buntinx. This review was based on 7 articles. All studies were published between 2010 and 2015. Five studies were retrospective studies, and 2 used an intervention. Three studies described foot and ankle kinematics in patients after fractures. Four studies described foot and ankle kinematics in patients after ankle sprain. In all included studies, altered foot and ankle kinematics were found compared with healthy subjects. No results on patient outcome using MSFMs and costs were found. Seven studies were found reporting foot and ankle kinematics in patients after foot and ankle trauma using an MSFM. Results show altered kinematics compared with healthy subjects, which cannot be seen by other diagnostic tests and add valuable data to the present literature; therefore, MSFMs seem to be promising diagnostic tools for evaluating foot and ankle kinematics. More research is needed to find the additional value for MSFMs regarding patient outcome and costs.
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Affiliation(s)
- Sander van Hoeve
- Professor, Division of Trauma Surgery, Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Martijn Poeze
- Professor, Division of Trauma Surgery, Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; Professor, School for Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht, The Netherlands
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Sanchis-Sales E, Sancho-Bru JL, Roda-Sales A, Pascual-Huerta J. Variability of the Dynamic Stiffness of Foot Joints: Effect of Gait Speed. J Am Podiatr Med Assoc 2019; 109:291-298. [PMID: 29131657 DOI: 10.7547/17-035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Comparison of dynamic stiffness of foot joints was previously proposed to investigate pathologic situations with changes in the properties of muscle and passive structures. Samples must be controlled to reduce the variability within groups being compared, which may arise from different sources, such as gait speed or Foot Posture Index (FPI). METHODS Variability in the measurement of the dynamic stiffness of ankle, midtarsal, and metatarsophalangeal joints was studied in a controlled sample of healthy men with normal FPI, and the effect of gait speed was analyzed. In experiment 1, dynamic stiffnesses were obtained in three sessions, five trials per session, for each participant, taking the mean value across trials as representative of each session. In experiment 2, five trials were considered at slow, comfortable, and fast velocities. RESULTS Similar intersession and intrasession errors and intraparticipant errors within sessions were found, indicating the goodness of using five trials per session for averaging. The intraparticipant and interparticipant variability data provided can be used to select the sample size in future comparative analyses. Significant differences with gait speed were observed in most dynamic stiffnesses considered, with a general rise when gait speed increased, especially at the midtarsal joint, this being attributed to an active modulation produced by the central nervous system. CONCLUSIONS Differences with gait speed were higher than intrasession and intersession repeatability errors for the propulsion phases at the ankle and midtarsal joints; comparative analyses at these phases need more exhaustive control of gait speed to reduce the required sample size.
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Park KN, Park SY. Description and Intrarater Test-Retest Reliability of a Reverse-Action Method to Assess Ankle Evertor Muscle Performance: The I-to-V Test. Physiother Can 2019; 70:306-313. [PMID: 30745715 DOI: 10.3138/ptc.2016-101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: Reverse action (RA) of the ankle evertor muscle is when the proximal attachment moves toward the distal attachment, moving the lower leg in the frontal plane when the foot and ankle are fixed on the ground and inducing ankle eversion. The purpose of this study was to describe an RA method for measuring ankle evertor muscle performance. Method: Eighteen healthy individuals were recruited for this study. To assess the RA of their ankle evertors, the participants sat with their knees together and their feet firmly planted on the floor, then spread their knees as far apart as possible. A tester used a measuring tape to measured the distance (in cm) between the medial tibial tuberosity of the tested side and that of the non-tested side. In the end range position of the RA, ankle evertor electromyographic activity was recorded simultaneously. The intra-class correlation coefficient (ICC) and standard error of measurement (SEM) were calculated to establish the intrarater test-retest reliability. The correlation between each performance value and muscle activity was assessed using a linear correlation model. Results: The proposed method of assessing RA performance was highly reliable (ICC=0.95) and had a low SEM (1.63 cm); in addition, the performance value showed a strong positive correlation with ankle evertor muscle activity (ρ=0.90; 95% CI: 0.79, 0.95; p=0.01). Conclusions: The proposed RA method of assessing the ankle evertor muscles can be used as a simple, reliable, economical performance test. It can also be used as an alternate method of testing the peroneal muscles rather than selectively measuring ankle evertor performance because hip external rotation occurs when performing RA.
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Affiliation(s)
- Kyue-Nam Park
- Department of Physical Therapy, College of Medical Science, Jeonju University, Jeonju
| | - So-Yeon Park
- Department of Physical Therapy, Sangji University, Wonju, South Korea
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An Ankle–Foot Prosthesis Emulator With Control of Plantarflexion and Inversion–Eversion Torque. IEEE T ROBOT 2018. [DOI: 10.1109/tro.2018.2830372] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Schneider HP, Baca JM, Carpenter BB, Dayton PD, Fleischer AE, Sachs BD. American College of Foot and Ankle Surgeons Clinical Consensus Statement: Diagnosis and Treatment of Adult Acquired Infracalcaneal Heel Pain. J Foot Ankle Surg 2018; 57:370-381. [PMID: 29284574 DOI: 10.1053/j.jfas.2017.10.018] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Indexed: 02/03/2023]
Abstract
Adult acquired inferior calcaneal heel pain is a common pathology seen in a foot and ankle practice. A literature review and expert panel discussion of the most common findings and treatment options are presented. Various diagnostic and treatment modalities are available to the practitioner. It is prudent to combine appropriate history and physical examination findings with patient-specific treatment modalities for optimum success. We present the most common diagnostic tools and treatment options, followed by a discussion of the appropriateness of each based on the published data and experience of the expert panel.
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Affiliation(s)
- Harry P Schneider
- Chairperson, Heel Pain Clinical Consensus Statement, Chicago, IL; Assistant Professor of Surgery, Harvard Medical School, Cambridge, MA; Residency Program Director, Cambridge Health Alliance, Cambridge, MA.
| | - John M Baca
- Private Practice, Dallas Podiatry Works, Dallas, TX
| | - Brian B Carpenter
- Professor, Department of Orthopedics, The University of North Texas Health Science Center, Fort Worth, TX; Private Practice, Paradise, TX
| | - Paul D Dayton
- Assistant Professor, College of Podiatric Medicine and Surgery, Des Moines, IA; Residency Program Director, UnityPoint Health, Fort Dodge, IA
| | - Adam E Fleischer
- Associate Professor, Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, IL; Director of Research, Weil Foot and Ankle Institute, Chicago, IL
| | - Brett D Sachs
- Private Practice, Rocky Mountain Foot & Ankle Center, Wheat Ridge, CO; Faculty, Highlands-Presbyterian/St. Luke's Podiatric Medicine and Surgery Residency Program, Denver, CO
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Bonifácio D, Richards J, Selfe J, Curran S, Trede R. Influence and benefits of foot orthoses on kinematics, kinetics and muscle activation during step descent task. Gait Posture 2018; 65:106-111. [PMID: 30558915 DOI: 10.1016/j.gaitpost.2018.07.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 07/06/2018] [Accepted: 07/11/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Medial wedged foot orthoses are frequently prescribed to reduce retropatellar stress in patients with patellofemoral pain (PFP) by controlling calcaneal eversion and internal rotation of the tibia. During activities of daily living, the highest patella loads occur during stair descent, but the effect of foot orthoses during stair descent remains unclear. RESEARCH QUESTION The purpose of this study was to compare the kinematics, kinetics and muscle activation during a step descent task in healthy volunteers using three designs of foot orthoses (insoles). METHODS Sixteen healthy subjects with a mean age of 25.7 years, BMI of 23.3, and +5 Foot Posture Index were recruited. Subjects performed a step down task from 20 cm using a 5o rearfoot medial wedge (R), a 5o rearfoot and forefoot medial wedge (R/F), and a control flat insole (C). RESULTS Significant improvements in control were seen in the R and R/F insoles over the C insole in the foot and at the ankle and hip kinematics. The R and R/F insoles increased the knee adduction moments, but reduced knee internal rotation moment compared to the C insole. Abductor hallucis (AH) activity was reduced with both insoles, whereas tibialis anterior (TA) activity was reduced with the R insole only. SIGNIFICANCE Foot orthoses can change joint mechanics in the foot and lower limbs providing greater stability and less work done by AH and TA muscles. This data supports the use of foot orthoses to provide functional benefits during step descent, which may benefit patients with PFP.
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Affiliation(s)
- Douglas Bonifácio
- Postgraduate Program in Rehabilitation and Functional Performance, UFVJM, Diamantina, Brazil
| | - Jim Richards
- Allied Health Research Unit, University of Central Lancashire, Preston, UK
| | - James Selfe
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Sarah Curran
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, UK
| | - Renato Trede
- Postgraduate Program in Rehabilitation and Functional Performance, UFVJM, Diamantina, Brazil.
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Muscle activity and kinetics of lower limbs during walking in pronated feet individuals with and without low back pain. J Electromyogr Kinesiol 2018; 39:35-41. [PMID: 29413451 DOI: 10.1016/j.jelekin.2018.01.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/05/2018] [Accepted: 01/17/2018] [Indexed: 11/21/2022] Open
Abstract
The objectives of this study were to investigate whether excessive feet pronation alters the joints' kinematics, kinetics and the activity of involved muscles during gait in low back pain patients. METHODS The lower limb joints' motion, moment and power, as well as the activity of involved muscles during walking were measured in a control group, and two experimental groups including a group with excessive feet pronation only, and another group of low back pain patients with excessive feet pronation. RESULTS In both experimental groups, ankle inversion, knee flexion and internal rotation, hip internal rotation, plantar flexors' moment, hip flexors' moment, and peak positive ankle power were lower than those in control group (p < .05). Besides, in patients, higher activity of gastrocnemius medialis, gluteus medius, erector spinae, and internal oblique muscles, and lower negative power at the ankle and peak positive power at the knee were observed (p < .05). In conclusion, pronated feet with low back pain was associated with less ankle inversion and knee flexion, higher knee and hip internal rotation, higher muscle activity, less energy absorption at the ankle, and reduced positive power at the knee. This study reveals that strengthening of the muscles especially knee extensors are of great importance in low back pain patients with feet pronation.
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Kim M, Collins SH. Step-to-Step Ankle Inversion/Eversion Torque Modulation Can Reduce Effort Associated with Balance. Front Neurorobot 2017; 11:62. [PMID: 29184493 PMCID: PMC5694462 DOI: 10.3389/fnbot.2017.00062] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 10/19/2017] [Indexed: 11/25/2022] Open
Abstract
Below-knee amputation is associated with higher energy expenditure during walking, partially due to difficulty maintaining balance. We previously found that once-per-step push-off work control can reduce balance-related effort, both in simulation and in experiments with human participants. Simulations also suggested that changing ankle inversion/eversion torque on each step, in response to changes in body state, could assist with balance. In this study, we investigated the effects of ankle inversion/eversion torque modulation on balance-related effort among amputees (N = 5) using a multi-actuated ankle-foot prosthesis emulator. In stabilizing conditions, changes in ankle inversion/eversion torque were applied so as to counteract deviations in side-to-side center-of-mass acceleration at the moment of intact-limb toe off; higher acceleration toward the prosthetic limb resulted in a corrective ankle inversion torque during the ensuing stance phase. Destabilizing controllers had the opposite effect, and a zero gain controller made no changes to the nominal inversion/eversion torque. To separate the balance-related effects of step-to-step control from the potential effects of changes in average mechanics, average ankle inversion/eversion torque and prosthesis work were held constant across conditions. High-gain stabilizing control lowered metabolic cost by 13% compared to the zero gain controller (p = 0.05). We then investigated individual responses to subject-specific stabilizing controllers following an enforced exploration period. Four of five participants experienced reduced metabolic rate compared to the zero gain controller (−15, −14, −11, −6, and +4%) an average reduction of 9% (p = 0.05). Average prosthesis mechanics were unchanged across all conditions, suggesting that improvements in energy economy might have come from changes in step-to-step corrections related to balance. Step-to-step modulation of inversion/eversion torque could be used in new, active ankle-foot prostheses to reduce walking effort associated with maintaining balance.
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Affiliation(s)
- Myunghee Kim
- Experimental Biomechatronics Laboratory, Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Steven H Collins
- Experimental Biomechatronics Laboratory, Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, United States.,Robotics Institute, Carnegie Mellon University, Pittsburgh, PA, United States.,Department of Mechanical Engineering, Stanford University, Stanford, CA, United States
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Sanchis-Sales E, Sancho-Bru JL, Roda-Sales A, Pascual-Huerta J. 3D characterisation of the dynamics of foot joints of adults during walking. Gait pattern identification. Comput Methods Biomech Biomed Engin 2017; 20:1015-1030. [PMID: 28521518 DOI: 10.1080/10255842.2017.1331343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A detailed description of the kinematics and kinetics of the ankle, midtarsal and metatarsophalangeal joints of the feet of a healthy adult male population during barefoot walking is provided. Plots of the angles and moments in each plane during the stance phase are reported, along with the mean and standard deviation values of 87 different parameters that characterise the 3D dynamics of the foot joints. These parameters were used to check for similarities between subjects through a hierarchical analysis that allowed three different gait patterns to be identified, most of the differences corresponding to the frontal and transverse planes.
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Affiliation(s)
- E Sanchis-Sales
- a Department de Podologia , Universitat de València , València , Spain
| | - J L Sancho-Bru
- b Department d'Enginyeria Mecànica i Construcció , Universitat Jaume I , Castelló , Spain
| | - A Roda-Sales
- b Department d'Enginyeria Mecànica i Construcció , Universitat Jaume I , Castelló , Spain
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Sanchis-Sales E, Sancho-Bru JL, Roda-Sales A, Pascual-Huerta J. Kinematics and kinetics analysis of midfoot joints of 30 normal subjects during walking. REVISTA ESPAÑOLA DE PODOLOGÍA 2016. [DOI: 10.1016/j.repod.2016.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Análisis cinético y cinemático de las articulaciones del mediopié durante la marcha en sujetos sanos: consideraciones clínicas. REVISTA ESPAÑOLA DE PODOLOGÍA 2016. [DOI: 10.1016/j.repod.2016.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Seybold JD, Campbell JT, Jeng CL, Short KW, Myerson MS. Outcome of Lateral Transfer of the FHL or FDL for Concomitant Peroneal Tendon Tears. Foot Ankle Int 2016; 37:576-81. [PMID: 26912032 DOI: 10.1177/1071100716634762] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Concomitant tears of the peroneus longus and brevis tendons are rare injuries, with literature limited to case reports and small patient series. Only 1 recent study directly compared the results of single-stage lateral deep flexor transfer, and no previous series objectively evaluated power and balance following transfer. The purpose of this study was to evaluate clinical outcomes, patient satisfaction, and objective power and balance data following single-stage flexor hallucis longus (FHL) and flexor digitorum longus (FDL) tendon transfers for treatment of concomitant peroneus longus and brevis tears. METHODS Over an 8-year period (2005-2012), 9 patients underwent lateral transfer of the FHL or FDL tendon for treatment of concomitant peroneus longus and brevis tears. All but 1 patient underwent additional procedures to address hindfoot malalignment or other contributing deformity at the time of surgery. Mean age was 56.9 years, and average body mass index was 27.9. Lateral transfer of the FHL was performed in 5 patients, and FDL transfer performed in 4 with mean follow-up 35.7 months (range: 11-94). Eight of 9 patients completed SF-12 and Foot Function Index (FFI) scores, and 7 returned for range of motion (ROM) and manual strength testing of the involved and normal extremities. These 7 patients also completed force plate balance tests, in addition to peak force and power testing on a PrimusRS machine with a certified physical therapist. RESULTS All patients were satisfied with the results of the procedure. Mean SF-12 physical and mental scores were 32 and 55, respectively; mean FFI total score was 56.7. No postoperative infections were noted. Two patients continued to utilize orthotics or braces, and 2 patients reported occasional pain with weightbearing activity. Three patients noted mild paresthesias in the distribution of the sural nerve and 2 demonstrated tibial neuritis. All patients demonstrated 4/5 eversion strength in the involved extremity. Average loss of inversion and eversion ROM were 24.7% and 27.2% of normal, respectively. Mean postoperative eversion peak force and power were decreased greater than 55% relative to the normal extremity. Patients demonstrated nearly 50% increases in both center-of-pressure tracing length and velocity during balance testing. There were no statistically significant differences between the FHL and FDL transfer groups with regards to clinical examination or objective power and balance tests. CONCLUSION The FHL and FDL tendons were both successful options for lateral transfer in cases of concomitant peroneus longus and brevis tears. Objective measurements of strength and balance demonstrated significant deficits in the operative extremity, even years following the procedure. These differences, however, did not appear to alter or inhibit patient activity levels or high satisfaction rates with the procedure. Although anatomic studies have demonstrated benefits of FHL transfer over the FDL tendon, further studies with increased patient numbers are needed to determine if these differences are clinically significant. LEVEL OF EVIDENCE Level IV, retrospective case series.
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Affiliation(s)
| | - John T Campbell
- Institute for Foot and Ankle Reconstruction, Mercy Medical Center, Baltimore, MD, USA
| | - Clifford L Jeng
- Institute for Foot and Ankle Reconstruction, Mercy Medical Center, Baltimore, MD, USA
| | - Kelly W Short
- Institute for Foot and Ankle Reconstruction, Mercy Medical Center, Baltimore, MD, USA
| | - Mark S Myerson
- Institute for Foot and Ankle Reconstruction, Mercy Medical Center, Baltimore, MD, USA
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Salsabili H, Bahrpeyma F, Esteki A. The effects of Task-Oriented Motor Training on gait characteristics of patients with type 2 diabetes neuropathy. J Diabetes Metab Disord 2016; 15:14. [PMID: 27231683 PMCID: PMC4881175 DOI: 10.1186/s40200-016-0236-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 05/01/2016] [Indexed: 12/01/2022]
Abstract
Background It is known that general gait training improves lower extremity muscle strength and endurance in Diabetes Neuropathy (DN). But, it is still unknown whether Task-Oriented (TO) gait training would change gait biomechanics and the risk of falling in DN. TO gait training focuses on promoting timing and coordination of lower extremity movements through goal-directed practices with sufficient repetition. Methods A group of 14 patients with DN participated in a time-series study. All subjects participated in four sessions of assessments (Initial, Pre, Post and Follow-Up). Training was twice a week for 12 weeks. Vertical and horizontal Ground Reaction Forces (GRF), Time Get up and Go (TGUG) and Fall Efficacy Scale-International (FES-I) were evaluated. Gait training started with stepping patterns that progressively changed to complicated patterns of walking. Then, training continued combining walking patterns with upper extremity activities and then ended with treadmill-paced practice. Results DN patients significantly increased Second Vertical Peak Force and Horizontal Propulsive Force in addition decrease in Minimum Vertical Force. TGUG significantly decreased while FES-I reflected significant increase after gait training. Discussion Conclusively, training not only improved gait performance, confidence in daily activities and attenuated risk of falling, but also helped DN patients to improve feet biomechanics, muscles timing and coordination. Conclusions Gait training with respect to principles of motor learning allowed patients to effectively improve through sessions.
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Affiliation(s)
- Hoda Salsabili
- Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Farid Bahrpeyma
- Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Esteki
- Medical Physics and Engineering Department, Shahid Beheshti University of Medical Science, Tehran, Iran
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Buldt AK, Levinger P, Murley GS, Menz HB, Nester CJ, Landorf KB. Foot posture is associated with kinematics of the foot during gait: A comparison of normal, planus and cavus feet. Gait Posture 2015; 42:42-8. [PMID: 25819716 DOI: 10.1016/j.gaitpost.2015.03.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 03/02/2015] [Accepted: 03/04/2015] [Indexed: 02/02/2023]
Abstract
Variations in foot posture are associated with the development of some lower limb injuries. However, the mechanisms underlying this relationship are unclear. The objective of this study was to compare foot kinematics between normal, pes cavus and pes planus foot posture groups using a multi-segment foot model. Ninety-seven healthy adults, aged 18-47 were classified as either normal (n=37), pes cavus (n=30) or pes planus (n=30) based on normative data for the Foot Posture Index, Arch Index and normalised navicular height. A five segment foot model was used to measure tri-planar motion of the rearfoot, midfoot, medial forefoot, lateral forefoot and hallux during barefoot walking at a self-selected speed. Angle at heel contact, peak angle, time to peak angle and range of motion was measured for each segment. One way ANOVAs with post-hoc analyses of mean differences were used to compare foot posture groups. The pes cavus group demonstrated a distinctive pattern of motion compared to the normal and pes planus foot posture groups. Effect sizes of significant mean differences were large and comparable to similar studies. Three key differences in overall foot function were observed between the groups: (i) altered frontal and transverse plane angles of the rearfoot in the pes cavus foot; (ii) Less midfoot motion in the pes cavus foot during initial contact and midstance; and (iii) reduced midfoot frontal plane ROM in the pes planus foot during pre-swing. These findings indicate that foot posture does influence motion of the foot.
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Affiliation(s)
- Andrew K Buldt
- Discipline of Podiatry, College of Science, Health and Engineering La Trobe University, Bundoora, VIC 3086, Australia; Lower Extremity and Gait Studies Program, College of Science, Health and Engineering La Trobe University, Bundoora, VIC 3086, Australia.
| | - Pazit Levinger
- Institute of Sport, Exercise & Active Living, College of Sport and Exercise Science Victoria University, Footscray, VIC 8001, Australia
| | - George S Murley
- Discipline of Podiatry, College of Science, Health and Engineering La Trobe University, Bundoora, VIC 3086, Australia; Lower Extremity and Gait Studies Program, College of Science, Health and Engineering La Trobe University, Bundoora, VIC 3086, Australia
| | - Hylton B Menz
- Lower Extremity and Gait Studies Program, College of Science, Health and Engineering La Trobe University, Bundoora, VIC 3086, Australia
| | | | - Karl B Landorf
- Discipline of Podiatry, College of Science, Health and Engineering La Trobe University, Bundoora, VIC 3086, Australia; Lower Extremity and Gait Studies Program, College of Science, Health and Engineering La Trobe University, Bundoora, VIC 3086, Australia
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Zuil-Escobar JC, Martínez-Cepa CB, Martín-Urrialde JA, Gómez-Conesa A. Prevalence of Myofascial Trigger Points and Diagnostic Criteria of Different Muscles in Function of the Medial Longitudinal Arch. Arch Phys Med Rehabil 2015; 96:1123-30. [DOI: 10.1016/j.apmr.2015.02.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 02/15/2015] [Accepted: 02/16/2015] [Indexed: 12/17/2022]
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Wegener C, Greene A, Burns J, Hunt AE, Vanwanseele B, Smith RM. In-shoe multi-segment foot kinematics of children during the propulsive phase of walking and running. Hum Mov Sci 2014; 39:200-11. [PMID: 25498288 DOI: 10.1016/j.humov.2014.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 11/03/2014] [Accepted: 11/05/2014] [Indexed: 11/16/2022]
Abstract
Certain styles of children's shoes reduce 1st metatarsophalangeal joint (MTPJ) and midfoot motion during propulsion of walking. However, no studies have investigated if the splinting effect of shoes on children's 1st MTPJ and midfoot motion occurs during running. This study investigated the effect of sports shoes on multi-segment foot kinematics of children during propulsion of walking and running. Twenty children walked and ran at a self-selected velocity while barefoot and shod in a random order. Reflective markers were used to quantify sagittal plane motion of the 1st MTPJ and three-dimensional motion of the midfoot and ankle. Gait velocity increased during shod walking and running and was considered a covariate in the statistical analysis. Shoes reduced 1st MTPJ motion during propulsion of walking from 36.0° to 10.7° and during running from 31.5° to 12.6°. Midfoot sagittal plane motion during propulsion reduced from 22.5° to 6.2° during walking and from 27.4° to 9.6° during running. Sagittal plane ankle motion during propulsion increased during shod running from 26.7° to 34.1°. During propulsion of walking and running, children's sports shoes have a splinting effect on 1st MTPJ and midfoot motion which is partially compensated by an increase in ankle plantarflexion during running.
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Affiliation(s)
- Caleb Wegener
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, NSW 1825, Australia.
| | - Andrew Greene
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, NSW 1825, Australia; Postgraduate Medical Institute, Faculty of Health, Social Care & Education, Anglia Ruskin University, Chelmsford, England, United Kingdom
| | - Joshua Burns
- The University of Sydney and The Children's Hospital at Westmead, Sydney, Australia
| | - Adrienne E Hunt
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, NSW 1825, Australia
| | - Benedicte Vanwanseele
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, NSW 1825, Australia; Department of Kinesiology, KU Leuven, Leuven, Belgium; Chair Health Innovation and Technology, Fontys University of Applied Sciences, Eindhoven, Netherlands
| | - Richard M Smith
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, NSW 1825, Australia
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Nester CJ, Jarvis HL, Jones RK, Bowden PD, Liu A. Movement of the human foot in 100 pain free individuals aged 18-45: implications for understanding normal foot function. J Foot Ankle Res 2014; 7:51. [PMID: 25493100 PMCID: PMC4260241 DOI: 10.1186/s13047-014-0051-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 11/10/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding motion in the normal healthy foot is a prerequisite for understanding the effects of pathology and thereafter setting targets for interventions. Quality foot kinematic data from healthy feet will also assist the development of high quality and research based clinical models of foot biomechanics. To address gaps in the current literature we aimed to describe 3D foot kinematics using a 5 segment foot model in a population of 100 pain free individuals. METHODS Kinematics of the leg, calcaneus, midfoot, medial and lateral forefoot and hallux were measured in 100 self reported healthy and pain free individuals during walking. Descriptive statistics were used to characterise foot movements. Contributions from different foot segments to the total motion in each plane were also derived to explore functional roles of different parts of the foot. RESULTS Foot segments demonstrated greatest motion in the sagittal plane, but large ranges of movement in all planes. All foot segments demonstrated movement throughout gait, though least motion was observed between the midfoot and calcaneus. There was inconsistent evidence of movement coupling between joints. There were clear differences in motion data compared to foot segment models reported in the literature. CONCLUSIONS The data reveal the foot is a multiarticular structure, movements are complex, show incomplete evidence of coupling, and vary person to person. The data provide a useful reference data set against which future experimental data can be compared and may provide the basis for conceptual models of foot function based on data rather than anecdotal observations.
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Affiliation(s)
- Christopher J Nester
- School of Health Sciences, University of Salford, PO 32 Brian Blatchford Building, Salford, M6 6PU UK
| | - Hannah L Jarvis
- School of Health Sciences, University of Salford, PO 32 Brian Blatchford Building, Salford, M6 6PU UK
| | - Richard K Jones
- School of Health Sciences, University of Salford, PO 32 Brian Blatchford Building, Salford, M6 6PU UK
| | - Peter D Bowden
- School of Health Sciences, University of Salford, PO 32 Brian Blatchford Building, Salford, M6 6PU UK
| | - Anmin Liu
- School of Health Sciences, University of Salford, PO 32 Brian Blatchford Building, Salford, M6 6PU UK
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Mayich DJ, Novak A, Vena D, Daniels TR, Brodsky JW. Gait analysis in orthopedic foot and ankle surgery--topical review, part 1: principles and uses of gait analysis. Foot Ankle Int 2014; 35:80-90. [PMID: 24220612 DOI: 10.1177/1071100713508394] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
UNLABELLED Gait analysis, the systematic study of human walking, is a field that has been studied for well over 100 years. With the technological and scientific advancements of the last several decades, there has been substantial improvement in our understanding of the mechanics of human walking. Particularly important has been the advancement in understanding of the differences between normal and pathological gait. The purpose of this paper is to review the principles of gait analysis, with a particular focus on the underlying methods and science. This will assist orthopedic foot and ankle surgeons in better understanding the methods and meaning of gait research and the publications that commonly appear in the orthopedic foot and ankle surgery literature. LEVEL OF EVIDENCE Level V, expert opinion.
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DE RIDDER ROEL, WILLEMS TINE, VANRENTERGHEM JOS, ROBINSON MARK, PATAKY TODD, ROOSEN PHILIP. Gait Kinematics of Subjects with Ankle Instability Using a Multisegmented Foot Model. Med Sci Sports Exerc 2013; 45:2129-36. [DOI: 10.1249/mss.0b013e31829991a2] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Burg J, Peeters K, Natsakis T, Dereymaeker G, Vander Sloten J, Jonkers I. In vitro analysis of muscle activity illustrates mediolateral decoupling of hind and mid foot bone motion. Gait Posture 2013; 38:56-61. [PMID: 23159677 DOI: 10.1016/j.gaitpost.2012.10.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 10/16/2012] [Accepted: 10/22/2012] [Indexed: 02/02/2023]
Abstract
Activity of the extrinsic ankle-foot muscles is typically described for the whole foot. This study determines if this muscle activity is also confirmed for individual foot segments defined in multi-segment foot models used for clinical gait analysis. Analysis of the individual bone motion can identify functional complexes within the foot and evaluates the influence of an altered foot position on muscle activity. A custom designed and built gait simulator incorporating pneumatic actuators is used to control the muscle force of six muscle groups in cadaveric feet. Measurements were performed in three static postures in which individual muscle force was incrementally changed. The motion of four bone embedded LED-clusters was measured using a Krypton motion capture system and resulting motion of calcaneus, talus, navicular and cuboid was calculated. Results indicate that primary muscle activity at bone level corresponds with that described for the whole foot. Secondary activity is not always coherent for bones within one segment: decoupling of the movement of medial and lateral foot bones is documented. Furthermore, secondary muscle activity can alter according to foot position. The observed medio-lateral decoupling of the foot bones dictates the need to extend some of the multi-segment foot models currently used in clinical gait analysis.
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Affiliation(s)
- Josefien Burg
- KU Leuven, Biomechanics Section, Celestijnenlaan 300C, Box 2419, 3001 Heverlee, Belgium.
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Chard A, Greene A, Hunt A, Vanwanseele B, Smith R. Effect of thong style flip-flops on children's barefoot walking and jogging kinematics. J Foot Ankle Res 2013; 6:8. [PMID: 23497571 PMCID: PMC3602234 DOI: 10.1186/1757-1146-6-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 02/26/2013] [Indexed: 11/24/2022] Open
Abstract
Background Thong style flip-flops are a popular form of footwear for children. Health professionals relate the wearing of thongs to foot pathology and deformity despite the lack of quantitative evidence to support or refute the benefits or disadvantages of children wearing thongs. The purpose of this study was to compare the effect of thong footwear on children’s barefoot three dimensional foot kinematics during walking and jogging. Methods Thirteen healthy children (age 10.3 ± 1.6 SD years) were recruited from the metropolitan area of Sydney Australia following a national press release. Kinematic data were recorded at 200 Hz using a 14 camera motion analysis system (Cortex, Motion Analysis Corporation, Santa Rosa, USA) and simultaneous ground reaction force were measured using a force platform (Model 9281B, Kistler, Winterthur, Switzerland). A three-segment foot model was used to describe three dimensional ankle, midfoot and one dimensional hallux kinematics during the stance sub-phases of contact, midstance and propulsion. Results Thongs resulted in increased ankle dorsiflexion during contact (by 10.9°, p; = 0.005 walk and by 8.1°, p; = 0.005 jog); increased midfoot plantarflexion during midstance (by 5.0°, p; = 0.037 jog) and propulsion (by 6.7°, p; = 0.044 walk and by 5.4°, p;= 0.020 jog); increased midfoot inversion during contact (by 3.8°, p;= 0.042 jog) and reduced hallux dorsiflexion during walking 10% prior to heel strike (by 6.5°, p; = 0.005) at heel strike (by 4.9°, p; = 0.031) and 10% post toe-off (by 10.7°, p; = 0.001). Conclusions Ankle dorsiflexion during the contact phase of walking and jogging, combined with reduced hallux dorsiflexion during walking, suggests a mechanism to retain the thong during weight acceptance. Greater midfoot plantarflexion throughout midstance while walking and throughout midstance and propulsion while jogging may indicate a gripping action to sustain the thong during stance. While these compensations exist, the overall findings suggest that foot motion whilst wearing thongs may be more replicable of barefoot motion than originally thought.
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Affiliation(s)
- Angus Chard
- Discipline of Exercise and Sport Science, Faculty of Health Science, The University of Sydney, Sydney, NSW, 2006, Australia.
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Resende RA, Nascimento LR, Silva MCL, Pinheiro AC, Fonseca ST, Kirkwood RN. Desenvolvimento de um modelo de pé segmentado para avaliação de indivíduos calçados. FISIOTERAPIA EM MOVIMENTO 2013. [DOI: 10.1590/s0103-51502013000100011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: O uso de calçados pode influenciar parâmetros cinemáticos dos segmentos do pé durante a marcha. OBJETIVO: Testar um modelo biomecânico para avaliar o deslocamento angular dos segmentos do pé durante a marcha de indivíduos calçados. MATERIAIS E MÉTODOS: Dez indivíduos adultos jovens saudáveis participaram do estudo. Um par de tênis foi utilizado durante o estudo. O sistema Qualisys Pró-Reflex foi utilizado para a avaliação das variáveis de desfecho: deslocamento angular de retropé nos planos sagital, frontal e transverso e de antepé nos planos frontal e transverso. O Coeficiente de Correlação Intraclasse foi usado para verificar o grau de associação das seguintes variáveis entre as duas visitas: valores angulares máximos e mínimos e deslocamento angular total. RESULTADOS: As variáveis de desfecho apresentaram confiabilidade teste-reteste de moderada a excelente. DISCUSSÃO: O nível de confiabilidade encontrado foi considerado aceitável, fornecendo, assim, uma base sólida para a avaliação objetiva da cinemática dos segmentos do pé de indivíduos calçados em ambientes laboratoriais, para fins de pesquisas científicas e avaliações clínicas da cinemática da marcha humana. CONCLUSÃO: A qualidade do método desenvolvido e da análise de confiabilidade realizada detectou padrões de movimento dos segmentos do pé próximos aos descritos na literatura. Além disso, o protocolo de aquisição apresentado não é invasivo, não requer uma estrutura extra de referência, posicionamento da articulação subtalar em neutro nem é dependente da informação fornecida por raios-X.
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De Mits S, Segers V, Woodburn J, Elewaut D, De Clercq D, Roosen P. A clinically applicable six-segmented foot model. J Orthop Res 2012; 30:655-61. [PMID: 22021089 DOI: 10.1002/jor.21570] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 09/26/2011] [Indexed: 02/04/2023]
Abstract
We describe a multi-segmented foot model comprising lower leg, rearfoot, midfoot, lateral forefoot, medial forefoot, and hallux for routine use in a clinical setting. The Ghent Foot Model describes the kinematic patterns of functional units of the foot, especially the midfoot, to investigate patient populations where midfoot deformation or dysfunction is an important feature, for example, rheumatoid arthritis patients. Data were obtained from surface markers by a 6 camera motion capture system at 500 Hz. Ten healthy subjects walked barefoot along a 12 m walkway at self-selected speed. Joint angles (rearfoot to shank, midfoot to rearfoot, lateral and medial forefoot to midfoot, and hallux to medial forefoot) in the sagittal, frontal, and transverse plane are reported according to anatomically based reference frames. These angles were calculated and reported during the foot rollover phases in stance, detected by synchronized plantar pressure measurements. Repeated measurements of each subject revealed low intra-subject variability, varying between 0.7° and 2.3° for the minimum values, between 0.5° and 2.1° for the maximum values, and between 0.8° and 5.8° for the ROM. The described movement patterns were repeatable and consistent with biomechanical and clinical knowledge. As such, the Ghent Foot model permits intersegment, in vivo motion measurement of the foot, which is crucial for both clinical and research applications.
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Affiliation(s)
- Sophie De Mits
- Rehabilitation Sciences and Physiotherapy, Ghent University and Artevelde University College, Ghent, Belgium.
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Peterson CL, Kautz SA, Neptune RR. Braking and propulsive impulses increase with speed during accelerated and decelerated walking. Gait Posture 2011; 33:562-7. [PMID: 21356590 PMCID: PMC3085638 DOI: 10.1016/j.gaitpost.2011.01.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 01/07/2011] [Accepted: 01/19/2011] [Indexed: 02/02/2023]
Abstract
The ability to accelerate and decelerate is important for daily activities and likely more demanding than maintaining a steady-state walking speed. Walking speed is modulated by anterior-posterior (AP) ground reaction force (GRF) impulses. The purpose of this study was to investigate AP impulses across a wide range of speeds during accelerated and decelerated walking. Kinematic and GRF data were collected from 10 healthy subjects walking on an instrumented treadmill. Subjects completed trials at steady-state speeds and at four rates of acceleration and deceleration across a speed range of 0-1.8 m/s. Mixed regression models were generated to predict AP impulses, step length and frequency from speed, and joint moment impulses from AP impulses during non-steady-state walking. Braking and propulsive impulses were positively related to speed. The braking impulse had a greater relationship with speed than the propulsive impulse, suggesting that subjects modulate the braking impulse more than the propulsive impulse to change speed. Hip and knee extensor, and ankle plantarflexor moment impulses were positively related to the braking impulse, and knee flexor and ankle plantarflexor moment impulses were positively related to the propulsive impulse. Step length and frequency increased with speed and were near the subjects' preferred combination at steady-state speeds, at which metabolic cost is minimized in nondisabled walking. Thus, these variables may be modulated to minimize metabolic cost while accelerating and decelerating. The outcomes of this work provide the foundation to investigate motor coordination in pathological subjects in response to the increased task demands of non-steady-state walking.
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Affiliation(s)
- Carrie L. Peterson
- Department of Mechanical Engineering, The University of Texas at Austin, TX
| | - Steven A. Kautz
- Ralph H Johnson VA Medical Center, Charleston, SC
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC
| | - Richard R. Neptune
- Department of Mechanical Engineering, The University of Texas at Austin, TX
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Landry SC, Nigg BM, Tecante KE. Standing in an unstable shoe increases postural sway and muscle activity of selected smaller extrinsic foot muscles. Gait Posture 2010; 32:215-9. [PMID: 20547062 DOI: 10.1016/j.gaitpost.2010.04.018] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Revised: 03/06/2010] [Accepted: 04/26/2010] [Indexed: 02/02/2023]
Abstract
Inactivity or the under-utilization of lower limb muscles can lead to strength and functional deficits and potential injury. Traditional shoes with stability and support features can overprotect the foot and potentially contribute to the deterioration of the smaller extrinsic foot muscles. Healthy subjects (n=28) stood in an unstable MBT (Masai Barefoot Technology) shoe during their work day for a 6-week accommodation period. A two-way repeated measures ANOVA was used to determine (i) if unstable shoe wear increased electromyographic (EMG) activity of selected extrinsic foot muscles and increased postural sway compared to standing barefoot and in a stable control shoe and (ii) if postural sway and muscle activity across footwear conditions differed between a pre- and post-accommodation testing visit. Using an EMG circumferential linear array, it was shown that standing in the unstable shoe increased activity of the flexor digitorum longus, peroneal (PR) and anterior compartment (AC) muscles of the lower leg. No activity differences for the larger soleus (SOL) were identified between the stable and unstable shoe conditions. Postural sway was greater while standing in the unstable shoe compared to barefoot and the stable control shoe. These findings suggest that standing in the unstable MBT shoe effectively activates selected extrinsic foot muscles and could have implications for strengthening and conditioning these muscles. Postural sway while standing in the unstable MBT shoe also decreased over the 6-week accommodation period.
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Affiliation(s)
- Scott C Landry
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, 2500 University Drive N.W., Calgary, Alberta, Canada T2N 1N4.
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Error in the description of foot kinematics due to violation of rigid body assumptions. J Biomech 2010; 43:666-72. [PMID: 19931085 DOI: 10.1016/j.jbiomech.2009.10.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Revised: 09/24/2009] [Accepted: 10/11/2009] [Indexed: 11/23/2022]
Abstract
Kinematic data from rigid segment foot models inevitably includes errors because the bones within each segment move relative to each other. This study sought to define error in foot kinematic data due to violation of the rigid segment assumption. The research compared kinematic data from 17 different mid and forefoot rigid segment models to kinematic data of the individual bones comprising these segments. Kinematic data from a previous dynamic cadaver model study was used to derive individual bone as well as foot segment kinematics. Mean and maximum errors due to violation of the rigid body assumption varied greatly between models. The model with least error was the combination of navicular and cuboid (mean errors < = 1.3 degrees, average maximum error < = 2.4 degrees). Greatest error was seen for the model combining all the ten bones (mean errors < = 4.4 degrees, average maximum errors < = 6.9 degrees). Based on the errors reported a three segment mid and forefoot model is proposed: (1) Navicular and cuboid, (2) cuneiforms and metatarsals 1, 2 and 3, and (3) metatarsals 4 and 5. However the utility of this model will depend on the precise purpose of the in vivo foot kinematics research study being undertaken.
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Cheung RTH, Ng GYF. Motion control shoe delays fatigue of shank muscles in runners with overpronating feet. Am J Sports Med 2010; 38:486-91. [PMID: 20194955 DOI: 10.1177/0363546509350738] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The motion control shoe is a well-developed technology in running shoe design for controlling excessive rearfoot pronation and plantar force distribution. However, there is little information on the leg muscle activation with different shoe conditions. HYPOTHESIS The motion control shoe can prevent excessive shank muscle activation and delay fatigue. STUDY DESIGN Controlled laboratory study. METHODS Twenty female recreational runners with excessive rearfoot pronation were tested with running 10 km on a treadmill on 2 days. Participants wore either a motion control running shoe or neutral running shoe on each day. Activities of their right tibialis anterior and peroneus longus were recorded with surface electromyography. The normalized root-mean-square electromyography and median frequency were compared between the 2 shoe conditions. RESULTS Significant positive correlations were found between the root-mean-square eletromyography and running mileage in both the tibialis anterior and peroneus longus in the neutral shoe condition (P <.001). The median frequency dropped in both shoe conditions with mileage, but paired t tests revealed a significantly larger drop in the neutral shoe (P < .001 for peroneus longus, P = .074 for tibialis anterior). CONCLUSION The motion control shoe may facilitate a more stable activation pattern and higher fatigue resistance of the tibialis anterior and peroneus longus in individuals with excessive rearfoot pronation during running. CLINICAL RELEVANCE The motion control shoe may increase the running endurance, thus reduce overuse injuries, in athletes with unstable feet during long-distance running.
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Affiliation(s)
- Roy T H Cheung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
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