scholarly journals Angle-angle diagrams in the assessment of locomotion in persons with multiple sclerosis: A preliminary study

2022 ◽  
Author(s):  
Riccardo Di Giminiani ◽  
Davide Di Lorenzo ◽  
Luca Russo ◽  
Stefano La Greca ◽  
Francesco Masedu ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Lower Limbs ◽  
Knee Angle ◽  
Long Term Effects ◽  
Leg Muscles ◽  
Ankle Angle ◽  
Spatiotemporal Parameters ◽  
Exercise Programmes

Gait analysis is clinically relevant in persons with multiple sclerosis (PwMS) and consists of several joint angular displace-ment-time relationships and spatiotemporal parameters. However, it lacks representation by means of diagrams in which knee angle-hip angle and knee angle-ankle angle variations are plotted against each other at the same instants of time. Three-dimensional kinematic analysis was performed on 20 subjects (10 PwMS/10 healthy controls, HCs), and the knee-angle/hip-angle and knee-angle/ankle-angle diagrams of both lower limbs were determined in the sagittal plane while walking on a motorized treadmill. The area (a quantifier of conjoint range of motion) and the perimeter (a quantifier of coordina-tion) of angle-angle diagram loops were calculated. PwMS showed reduced knee-angle/ankle-angle loops compared to HCs (P<0.05, ES = 0.80), whereas the hip-angle/ankle-angle loops between the PwMS and HCs was not significant (P> 0.05). Similarly, the activation of leg muscles showed significant differences between PwMS and HCs (p ranged from 0.05-to 0.001; ES ranged from 1.30 to 1.89). The results indicate that the proposed knee-angle/hip-angle diagram is feasible and could be applied as a reliable tool in future studies aimed at assessing the acute and long-term effects of specific exercise programmes and/or pharmacological treatment in PwMS.

The influence of selected manual techniques on the relative length of lower limbs in children with postural defects – a pilot study

2018 ◽  
Vol 1 (2) ◽  
pp. 21-27
Author(s):  
Mirosław KAPICA ◽  
Agnieszka JANKOWICZ-SZYMAŃSKA ◽  
Teresa GNIEWEK ◽  
Radosław RAŹNIEWSKI ◽  
Andrzej ŻYTKOWSKI ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
Three Dimensional ◽  
Relative Length ◽  
Lower Limbs ◽  
School Age Children ◽  
Leg Length ◽  
Therapeutic Tool ◽  
Before And After ◽  
Postural Abnormalities ◽  
Selection Of

Introduction: One of the very important indicators used in the treatment of postural defects is the relative symmetry of the lower limbs. The selection of a safe and effective therapeutic tool is not an easy task and is particularly important in children. The authors of the experiment have decided to check the effectiveness of two manual techniques, that minimally interfere with patient's tissues. The objective of this study was to evaluate the influence of selected manual procedures: the Ackerman's second phenomenon and mobilization of the sacroiliac joint to hyperextension (Kowtun's grip) on the relative length of the lower limbs in a school-age children. Materials and methods: 70 children aged 8-12 participated in the study. All of them were diagnosed with postural abnormalities: spine defects in the sagittal plane, three-dimensional asymmetry of the torso, knee and / or foot defects and asymmetry of the length of the lower limbs. Qualification of children for a particular group with a postural defects was based on the concept of Sastre Fernandez. In each patient, the manual procedure in order to compensate the leg length, was applied once. In 28 children the applied procedure was the Ackerman's second phenomenon and in 42 it was the Kowtun's grip. The relative length of t h e l o w e r l i m b s w a s m e a s u r e d immediately before and after the manual procedure. Results: The executed experiment indicates the effectiveness of the Ackerman's second phenomenon in compensating the asymmetry of the length of the lower limbs in children with posture defects. The effect of Kovtun's mobilization is less clear. Conclusions: Manual procedure change the relative length of the lower limbs in children with postural defects. The Ackerman's second phenomenon in an effective and yet gentle and safe manual tool that can be used in children in order to compensate the relative length of the lower limbs. The effect of the Kowtun's treatment requires further research.

scholarly journals A Comparison of Dynamic and Static Hip-Knee-Ankle Angle during Gait in Knee Osteoarthritis Patients and Healthy Individuals

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Li Zhang ◽  
Geng Liu ◽  
Bing Han ◽  
Yuzhou Yan ◽  
Junhua Fei ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Healthy Subjects ◽  
Gait Cycle ◽  
Three Dimensional ◽  
Lower Limbs ◽  
Ankle Angle ◽  
The Mean ◽  
The Relationship ◽  
Hip Knee Ankle Angle ◽  
Healthy Participants

Malalignment of the lower limbs is the main biomechanical factor for knee osteoarthritis (KOA). The static hip-knee-ankle angle (S-HKAA) measured from radiograph is regarded as the “gold standard” of the malalignment. However, many evidences showed that the S-HKAA has no significant correlation with the knee dynamic-load distribution, unlike the dynamic HKAA (D-HKAA). The purpose of this study was to quantitatively analyze the D-HKAA and investigate the relationship between D-HKAA and S-HKAA for both KOA and healthy participants. In this paper, twenty-five healthy subjects and twenty-five medial compartment KOA (M-KOA) patients were recruited. Three-dimensional motion analysis and standing lower-limbs-full-length radiograph were utilized to obtain the D-HKAA and S-HKAA, respectively. The results showed that the mean D-HKAA was more varus than the S-HKAA ( p < 0.05 ). For the mean D-HKAA, larger varus angle was observed in swing phase than stance phase ( p < 0.05 ). Compared with healthy subjects, the M-KOA patients had remarkably smaller S-HKAA and D-HKAA during gait cycle ( p < 0.01 ). For the relationship between the S-HKAA and mean D-HKAA, no significant correlation was found for both healthy subjects and M-KOA patients ( r < 0.357 , n = 25 , p > 0.05 , Spearman correlation analysis). In conclusion, the S-HKAA was limited to predict the D-HKAA for both M-KOA patients and healthy subjects. The D-HKAA should be given more attention to the orthopedist and the designer of knee brace and orthotics.

scholarly journals Variability of ankle kinematics in professional cyclists: consequence on saddle height adjustment

2020 ◽  
Vol 9 (1) ◽  
pp. 25-32
Author(s):  
Geoffrey Millour ◽  
Sebastien Duc ◽  
Theo Ouvrard ◽  
Damien Segui ◽  
Frederic Puel ◽  
...  
Keyword(s):  
Coefficient Of Variation ◽  
Sagittal Plane ◽  
Knee Kinematics ◽  
Knee Extension ◽  
Individual Variability ◽  
Great Variability ◽  
Knee Angle ◽  
Optimal Range ◽  
Ankle Kinematics ◽  
Ankle Angle

Bike-fitting methods based on the knee kinematics have been developed to determine the optimal saddle height. Among them, the Ferrer-Roca method advises a knee angle between 30 and 40° in the sagittal plane when the crank arm is aligned with the seat tube while pedalling. However, the foot orientation varies between individuals and can influence the knee angle throughout the pedalling cycle. The objective of this study was to measure the inter-individual variability in joint kinematics of professional cyclists and to evaluate the influence of the ankle angle modification on the knee angle during pedalling. Seventeen professional cyclists performed a 3-min pedalling test at 150 W and 80 rpm on their personal road bike mounted on an Elite Turno® ergometer (Elite, Fontaniva, Italia). The knee and ankle angles were measured using 2D kinematic analysis. The average knee angle (38°) was in the optimal range of 30–40°, but great variability was observed between individuals (coefficient of variation of 11.8% and 9.4% for knee and ankle angles, respectively). Moreover, five of them had a knee angle greater than 40°. In addition, their ankle angle was 15% lower than that of cyclists who had a knee angle between 30 and 40° (50 ± 4° vs. 58 ± 4°, p < 0.05). The results suggest that the knee angle observed when professional cyclists use their preferred saddle height varies among individuals and is related to the foot orientation while pedalling. The maximum knee extension angle is lower for the cyclists who accentuate the dorsiflexion but greater for those who pedalled with a plantarflexion. This implies that the saddle height adjustment method based on the knee kinematics while pedalling should consider both the knee and ankle angles.

scholarly journals A Comparison of Static and Dynamic Measures of Lower Limb Joint Angles in Cycling: Application to Bicycle Fitting

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Rodrigo Rico Bini ◽  
Patria Hume
Keyword(s):  
Lower Limb ◽  
Sagittal Plane ◽  
Digital Camera ◽  
Gear Ratio ◽  
Knee Angle ◽  
Joint Angles ◽  
Ankle Angle ◽  
Dynamic Measures ◽  
Potential Use ◽  
Dynamic Cycling

AbstractPurpose. Configuration of bicycle components to the cyclist (bicycle fitting) commonly uses static poses of the cyclist on the bicycle at the 6 o’clock crank position to represent dynamic cycling positions. However, the validity of this approach and the potential use of the different crank position (e.g. 3 o’clock) have not been fully explored. Therefore, this study compared lower limb joint angles of cyclists in static poses (3 and 6 o’clock) compared to dynamic cycling. Methods. Using a digital camera, right sagittal plane images were taken of thirty cyclists seated on their own bicycles mounted on a stationary trainer with the crank at 3 o’clock and 6 o’clock positions. Video was then recorded during pedalling at a self-selected gear ratio and pedalling cadence. Sagittal plane hip, knee and ankle angles were digitised. Results. Differences between static and dynamic angles were large at the 6 o’clock crank position with greater mean hip angle (4.9 ± 3°), smaller knee angle (8.2 ± 5°) and smaller ankle angle (8.2 ± 5.3°) for static angles. Differences between static and dynamic angles (< 1.4°) were trivial to small for the 3 o’clock crank position. Conclusions. To perform bicycle fitting, joint angles should be measured dynamically or with the cyclist in a static pose at the 3 o’clock crank position.

scholarly journals Analysis of Different Stop-Jumping Strategies on the Biomechanical Changes in the Lower Limbs

2021 ◽  
Vol 11 (10) ◽  
pp. 4633
Author(s):  
Huiyu Zhou ◽  
Datao Xu ◽  
Chaoyi Chen ◽  
Ukadike Chris Ugbolue ◽  
Julien S. Baker ◽  
...  
Keyword(s):  
Contact Area ◽  
Knee Injury ◽  
Statistical Parametric Mapping ◽  
Lower Limbs ◽  
Initial Contact ◽  
Knee Angle ◽  
Acl Injuries ◽  
Ankle Angle ◽  
Biomechanical Changes ◽  
Biomechanical Parameters

The stop-jumping task is one of the most important technical actions in basketball. A previous study showed 70% probability of non-contact ACL injuries during stop-jumping tasks. Therefore, the present study aimed to investigate the differences in lower extremity biomechanical changes between the rear foot as the initial contact area to terminate the jump (SJR) and the fore foot as the initial contact area to also terminate the jump (SJF) during the horizontal landing during a stop-jumping phase. In total, 25 male amateur Ningbo University basketball athletes from China were recruited for this study. The participants were asked to jump vertically by using two different stop-jumping strategies. Kinematic and kinetics data were amassed during a stop-jumping task. Statistical parametric mapping (SPM) analysis was used to find the differences between SJR and SJF. Our results indicated that the change of different ankle range of motion caused significantly different values for knee angle (p < 0.001), velocity (p = 0.003) (p = 0.023) (p < 0.001), moment (p = 0.04) (p < 0.001), (p = 0.036) and power (p = 0.015) (p < 0.001) during the stop-jumping phase and the horizontal landing phase. The same biomechanical parameters of the hip joint were also significantly different for hip angle (p < 0.001), moment (p = 0.012) (p < 0.001) (p < 0.001), and power (p = 0.01) (p < 0.001) (p < 0.001). These findings indicate that altering the primary contact at the ankle angle might effectively reduce the risk of a knee injury.

Custom Presurgical Planning for Midfacial Reconstruction

2020 ◽  
Vol 36 (06) ◽  
pp. 696-702
Author(s):  
Nolan B. Seim ◽  
Enver Ozer ◽  
Sasha Valentin ◽  
Amit Agrawal ◽  
Mead VanPutten ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Functional Performance ◽  
Three Dimensional ◽  
Free Tissue Transfer ◽  
Long Term Effects ◽  
Presurgical Planning ◽  
Dental Rehabilitation ◽  
Midface Reconstruction ◽  
Reconstructive Algorithm

AbstractResection and reconstruction of midface involve complex ablative and reconstructive tools in head and oncology and maxillofacial prosthodontics. This region is extraordinarily important for long-term aesthetic and functional performance. From a reconstructive standpoint, this region has always been known to present challenges to a reconstructive surgeon due to the complex three-dimensional anatomy, the variable defects created, combination of the medical and dental functionalities, and the distance from reliable donor vessels for free tissue transfer. Another challenge one faces is the unique features of each individual resection defect as well as individual patient factors making each preoperative planning session and reconstruction unique. Understanding the long-term effects on speech, swallowing, and vision, one should routinely utilize a multidisciplinary approach to resection and reconstruction, including head and neck reconstructive surgeons, prosthodontists, speech language pathologists, oculoplastic surgeons, dentists, and/or craniofacial teams as indicated and with each practice pattern. With this in mind, we present our planning and reconstructive algorithm in midface reconstruction, including a dedicated focus on dental rehabilitation via custom presurgical planning.

Correction of Posture Deviations in the Sagittal Plane Using the Pilates Method

2019 ◽  
pp. 3-13
Author(s):  
Alexandru Cîtea ◽  
George-Sebastian Iacob
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Postural Control ◽  
Human Body ◽  
Sagittal Plane ◽  
The Body ◽  
Lower Limbs ◽  
Low Back ◽  
Pilates Method ◽  
The Relationship

Posture is commonly perceived as the relationship between the segments of the human body upright. Certain parts of the body such as the cephalic extremity, neck, torso, upper and lower limbs are involved in the final posture of the body. Musculoskeletal instabilities and reduced postural control lead to the installation of nonstructural posture deviations in all 3 anatomical planes. When we talk about the sagittal plane, it was concluded that there are 4 main types of posture deviation: hyperlordotic posture, kyphotic posture, rectitude and "sway-back" posture.Pilates method has become in the last decade a much more popular formof exercise used in rehabilitation. The Pilates method is frequently prescribed to people with low back pain due to their orientation on the stabilizing muscles of the pelvis. Pilates exercise is thus theorized to help reactivate the muscles and, by doingso, increases lumbar support, reduces pain, and improves body alignment.

scholarly journals Kinematic Analysis of Lower Limb Joint Asymmetry during Gait in People with Multiple Sclerosis

Symmetry ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 598
Author(s):  
Massimiliano Pau ◽  
Bruno Leban ◽  
Michela Deidda ◽  
Federica Putzolu ◽  
Micaela Porta ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Lower Limb ◽  
Sagittal Plane ◽  
Cross Sectional Study ◽  
Camera Motion ◽  
Cross Sectional ◽  
Temporal Parameters ◽  
Wide Range ◽  
Edss Score ◽  
Spatio Temporal

The majority of people with Multiple Sclerosis (pwMS), report lower limb motor dysfunctions, which may relevantly affect postural control, gait and a wide range of activities of daily living. While it is quite common to observe a different impact of the disease on the two limbs (i.e., one of them is more affected), less clear are the effects of such asymmetry on gait performance. The present retrospective cross-sectional study aimed to characterize the magnitude of interlimb asymmetry in pwMS, particularly as regards the joint kinematics, using parameters derived from angle-angle diagrams. To this end, we analyzed gait patterns of 101 pwMS (55 women, 46 men, mean age 46.3, average Expanded Disability Status Scale (EDSS) score 3.5, range 1–6.5) and 81 unaffected individuals age- and sex-matched who underwent 3D computerized gait analysis carried out using an eight-camera motion capture system. Spatio-temporal parameters and kinematics in the sagittal plane at hip, knee and ankle joints were considered for the analysis. The angular trends of left and right sides were processed to build synchronized angle–angle diagrams (cyclograms) for each joint, and symmetry was assessed by computing several geometrical features such as area, orientation and Trend Symmetry. Based on cyclogram orientation and Trend Symmetry, the results show that pwMS exhibit significantly greater asymmetry in all three joints with respect to unaffected individuals. In particular, orientation values were as follows: 5.1 of pwMS vs. 1.6 of unaffected individuals at hip joint, 7.0 vs. 1.5 at knee and 6.4 vs. 3.0 at ankle (p < 0.001 in all cases), while for Trend Symmetry we obtained at hip 1.7 of pwMS vs. 0.3 of unaffected individuals, 4.2 vs. 0.5 at knee and 8.5 vs. 1.5 at ankle (p < 0.001 in all cases). Moreover, the same parameters were sensitive enough to discriminate individuals of different disability levels. With few exceptions, all the calculated symmetry parameters were found significantly correlated with the main spatio-temporal parameters of gait and the EDSS score. In particular, large correlations were detected between Trend Symmetry and gait speed (with rho values in the range of –0.58 to –0.63 depending on the considered joint, p < 0.001) and between Trend Symmetry and EDSS score (rho = 0.62 to 0.69, p < 0.001). Such results suggest not only that MS is associated with significantly marked interlimb asymmetry during gait but also that such asymmetry worsens as the disease progresses and that it has a relevant impact on gait performances.

scholarly journals Sirenomelia: two case reports

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Asiyeh Shojaee ◽  
Firooze Ronnasian ◽  
Mahdiyeh Behnam ◽  
Mansoor Salehi
Keyword(s):  
Case Reports ◽  
Three Dimensional ◽  
First Trimester ◽  
Mendelian Inheritance ◽  
Lower Limbs ◽  
Congenital Deformity ◽  
White Family ◽  
Her Family ◽  
Caudal Regression ◽  
History Of

AbstractBackgroundSirenomelia, also called mermaid syndrome, is a rare lethal multi-system congenital deformity with an incidence of one in 60,000–70,000 pregnancies. Sirenomelia is mainly characterized by the fusion of lower limbs and is widely associated with severe urogenital and gastrointestinal malformations. The presence of a single umbilical artery derived from the vitelline artery is the main anatomical feature distinguishing sirenomelia from caudal regression syndrome. First-trimester diagnosis of this disorder and induced abortion may be the safest medical option. In this report, two cases of sirenomelia that occurred in an white family will be discussed.Case presentationWe report two white cases of sirenomelia occurring in a 31-year-old multigravid pregnant woman. In the first pregnancy (18 weeks of gestation) abortion was performed, but in the third pregnancy (32 weeks) the stillborn baby was delivered by spontaneous vaginal birth. In the second and fourth pregnancies, however, she gave birth to normal babies. Three-dimensional ultrasound imaging showed fusion of the lower limbs. Neither she nor any member of her family had a history of diabetes. In terms of other risk factors, she had no history of exposure to teratogenic agents during her pregnancy. Also, her marriage was non-consanguineous.ConclusionThis report suggests the existence of a genetic background in this mother with a Mendelian inheritance pattern of 50% second-generation incidence in her offspring.

scholarly journals Analysis of 3-D Kinematics Using H-Gait System during Walking on a Lower Body Positive Pressure Treadmill

Sensors ◽  
2021 ◽  
Vol 21 (8) ◽  
pp. 2619
Author(s):  
Yoshiaki Kataoka ◽  
Ryo Takeda ◽  
Shigeru Tadano ◽  
Tomoya Ishida ◽  
Yuki Saito ◽  
...  
Keyword(s):  
Motion Analysis ◽  
Wearable Sensors ◽  
Three Dimensional ◽  
Lower Limbs ◽  
Positive Pressure ◽  
Lower Body ◽  
Lower Body Positive Pressure ◽  
Gait Kinematics ◽  
Peak Knee ◽  
Body Positive

Recently, treadmills equipped with a lower-body positive-pressure (LBPP) device have been developed to provide precise body weight support (BWS) during walking. Since lower limbs are covered in a waist-high chamber of an LBPP treadmill, a conventional motion analysis using an optical method is impossible to evaluate gait kinematics on LBPP. We have developed a wearable-sensor-based three-dimensional motion analysis system, H-Gait. The purpose of the present study was to investigate the effects of BWS by a LBPP treadmill on gait kinematics using an H-Gait system. Twenty-five healthy subjects walked at 2.5 km/h on a LBPP treadmill under the following three conditions: (1) 0%BWS, (2) 25%BWS and (3) 50%BWS conditions. Acceleration and angular velocity from seven wearable sensors were used to analyze lower limb kinematics during walking. BWS significantly decreased peak angles of hip adduction, knee adduction and ankle dorsiflexion. In particular, the peak knee adduction angle at the 50%BWS significantly decreased compared to at the 25%BWS (p = 0.012) or 0%BWS (p < 0.001). The present study showed that H-Gait system can detect the changes in gait kinematics in response to BWS by a LBPP treadmill and provided a useful clinical application of the H-Gait system to walking exercises.

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