Effect of Foot Progression Angle and Lateral Wedge Insole on a Reduction in Knee Adduction Moment

2016 ◽  
Vol 32 (5) ◽  
pp. 454-461 ◽  
Author(s):  
Ken Tokunaga ◽  
Yuki Nakai ◽  
Ryo Matsumoto ◽  
Ryoji Kiyama ◽  
Masayuki Kawada ◽  
...  
Keyword(s):  
Ground Reaction Force ◽  
Reaction Force ◽  
Reduction Ratio ◽  
Knee Adduction Moment ◽  
Moment Arm ◽  
3 Dimensional ◽  
Foot Progression Angle ◽  
Close Relationship ◽  
The Moment ◽  
Joint Center

This study evaluated the effect of foot progression angle on the reduction in knee adduction moment caused by a lateral wedged insole during walking. Twenty healthy, young volunteers walked 10 m at their comfortable velocity wearing a lateral wedged insole or control flat insole in 3 foot progression angle conditions: natural, toe-out, and toe-in. A 3-dimensional rigid link model was used to calculate the external knee adduction moment, the moment arm of ground reaction force to knee joint center, and the reduction ratio of knee adduction moment and moment arm. The result indicated that the toe-out condition and lateral wedged insole decreased the knee adduction moment in the whole stance phase. The reduction ratio of the knee adduction moment and the moment arm exhibited a close relationship. Lateral wedged insoles decreased the knee adduction moment in various foot progression angle conditions due to decrease of the moment arm of the ground reaction force. Moreover, the knee adduction moment during the toe-out gait with lateral wedged insole was the smallest due to the synergistic effect of the lateral wedged insole and foot progression angle. Lateral wedged insoles may be a valid intervention for patients with knee osteoarthritis regardless of the foot progression angle.

The Influence of Heel Lift Manipulation on Achilles Tendon Loading in Running

1998 ◽  
Vol 14 (4) ◽  
pp. 374-389 ◽  
Author(s):  
Sharon J. Dixon ◽  
David G. Kerwin
Keyword(s):  
Achilles Tendon ◽  
Ground Reaction Force ◽  
Reaction Force ◽  
Tendon Injury ◽  
Moment Arm ◽  
The Common ◽  
Tendon Force ◽  
The Moment ◽  
Joint Center ◽  
Heel Lift

In this study, a modeling method was developed to estimate Achilles tendon forces in running. Owing to the common use of heel lift devices in the treatment of Achilles tendon injury, we investigated the influence of increased heel lift on Achilles tendon loading. The hypothesis was that heel lift manipulation can influence maximum Achilles tendon force. Responses to heel lift variation were found to differ among 3 elite runners demonstrating distinct running styles. A rearfoot and a midfoot striker demonstrated significant increases in maximum Achilles tendon force with increased heel lift, whereas a forefoot striker demonstrated no changes in maximum Achilles tendon force values with heel lift manipulation (p < .05). Analysis of the factors contributing to the observed changes in maximum Achilles tendon force highlighted the influence of the moment arm of ground reaction force and the moment arm of the Achilles tendon about the ankle joint center. The finding that increased heel lift may increase maximum Achilles tendon force suggests that caution is advised in the routine use of this intervention. The different responses to heel lift increase between subjects highlight the importance of classifying subjects based on running style.

The Effects of a Lateral Wedge Insole on Knee and Ankle Joints During Slope Walking

2015 ◽  
Vol 31 (6) ◽  
pp. 476-483 ◽  
Author(s):  
Yuki Uto ◽  
Tetsuo Maeda ◽  
Ryoji Kiyama ◽  
Masayuki Kawada ◽  
Ken Tokunaga ◽  
...  
Keyword(s):  
Ground Reaction Force ◽  
Reaction Force ◽  
Force Plate ◽  
Three Dimensional ◽  
Frontal Plane ◽  
Knee Adduction Moment ◽  
Moment Arm ◽  
Level Walking ◽  
Ankle Valgus ◽  
The Moment

The purpose of this study was to determine whether a lateral wedge insole reduces the external knee adduction moment during slope walking. Twenty young, healthy subjects participated in this study. Subjects walked up and down a slope using 2 different insoles: a control flat insole and a 7° lateral wedge insole. A three-dimensional motion analysis system and force plate were used to examine the knee adduction moment, the ankle valgus moment, and the moment arm of the ground reaction force to the knee joint center in the frontal plane. The lateral wedge insole significantly decreased the moment arm of the ground reaction force, resulting in a reduction of the knee adduction moment during slope walking, similar to level walking. The reduction ratio of knee adduction moment by the lateral wedge insole during the early stance of up-slope walking was larger than that of level walking. Conversely, the lateral wedge insole increased the ankle valgus moment during slope walking, especially during the early stance phase of up-slope walking. Clinicians should examine the utilization of a lateral wedge insole for knee osteoarthritis patients who perform inclined walking during daily activity, in consideration of the load on the ankle joint.

scholarly journals Lower Limb Joint Kinetics During Moderately Sloped Running

2010 ◽  
Vol 45 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Gaurav Telhan ◽  
Jason R. Franz ◽  
Jay Dicharry ◽  
Robert P. Wilder ◽  
Patrick O. Riley ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Ground Reaction Force ◽  
Injury Risk ◽  
Reaction Force ◽  
Surface Slope ◽  
Joint Moments ◽  
Joint Kinetics ◽  
3 Dimensional ◽  
Modifiable Factors ◽  
The Impact

Abstract Context: Knowledge of the kinetic changes that occur during sloped running is important in understanding the adaptive gait-control mechanisms at work and can provide additional information about the poorly understood relationship between injury and changes in kinetic forces in the lower extremity. A study of these potential kinetic changes merits consideration, because training and return-to-activity programs are potentially modifiable factors for tissue stress and injury risk. Objective: To contribute further to the understanding of hill running by quantifying the 3-dimensional alterations in joint kinetics during moderately sloped decline, level, and incline running in a group of healthy runners. Design: Crossover study. Setting: Three-dimensional motion analysis laboratory. Patients or Other Participants: Nineteen healthy young runners/joggers (age  =  25.3 ± 2.5 years). Intervention(s): Participants ran at 3.13 m/s on a treadmill under the following 3 different running-surface slope conditions: 4° decline, level, and 4° incline. Main Outcome Measure(s): Lower extremity joint moments and powers and the 3 components of the ground reaction force. Results: Moderate changes in running-surface slope had a minimal effect on ankle, knee, and hip joint kinetics when velocity was held constant. Only changes in knee power absorption (increased with decline-slope running) and hip power (increased generation on incline-slope running and increased absorption on decline-slope running in early stance) were noted. We observed an increase only in the impact peak of the vertical ground reaction force component during decline-slope running, whereas the nonvertical components displayed no differences. Conclusions: Running style modifications associated with running on moderate slopes did not manifest as changes in 3-dimensional joint moments or in the active peaks of the ground reaction force. Our data indicate that running on level and moderately inclined slopes appears to be a safe component of training regimens and return-to-run protocols after injury.

scholarly journals A Hybrid Method for Computing Achilles Tendon Moment Arm Using Ultrasound and Motion Analysis

2010 ◽  
Vol 26 (2) ◽  
pp. 224-228 ◽  
Author(s):  
Kurt Manal ◽  
Justin D. Cowder ◽  
Thomas S. Buchanan
Keyword(s):  
Achilles Tendon ◽  
Motion Capture ◽  
Hybrid Method ◽  
Moment Arm ◽  
Measurement Instruments ◽  
Moment Arms ◽  
Perpendicular Distance ◽  
The Moment ◽  
Joint Center

In this article, we outline a method for computing Achilles tendon moment arm. The moment arm is computed from data collected using two reliable measurement instruments: ultrasound and video-based motion capture. Ultrasound is used to measure the perpendicular distance from the surface of the skin to the midline of the tendon. Motion capture is used to determine the perpendicular distance from the bottom of the probe to the ankle joint center. The difference between these two measures is the Achilles tendon moment arm. Unlike other methods, which require an angular change in joint position to approximate the moment arm, the hybrid method can be used to compute the moment arm directly at a specific joint angle. As a result, the hybrid method involves fewer error-prone measurements and the moment arm can be computed at the limits of the joint range of motion. The method is easy to implement and uses modalities that are less costly and more accessible than MRI. Preliminary testing using a lamb shank as a surrogate for a human ankle revealed good accuracy (3.3% error). We believe the hybrid method outlined here can be used to measure subject-specific moment arms in vivo and thus will potentially benefit research projects investigating ankle mechanics.

scholarly journals The Use of Weight-Bearing CT Scan in the Evaluation of Hindfoot Alignment

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Jonathan Kaplan ◽  
Mark Myerson ◽  
Matthew Welck ◽  
Joseph Tracey ◽  
Adriana Avila ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Ground Reaction Force ◽  
Weight Bearing ◽  
Reaction Force ◽  
Measurement Techniques ◽  
Ct Scans ◽  
Hindfoot Alignment ◽  
3 Dimensional ◽  
Observer Reliability ◽  
Ct Technique

Category: Hindfoot, Diagnostic Imaging Introduction/Purpose: Multiple techniques have been described in determining the hindfoot alignment radiographically. While these studies have traditionally showed good reliability, the 2-dimensional nature of radiographs fails to consider the contribution of the remainder of the foot on the overall alignment. A new technique has been recently published in which the hindfoot alignment is calculated using the Ground Reaction Force Calcaneal Offset off radiographs. This technique accounts for the individual forefoot contributions on overall alignment, however is still limited by the 2-dimensional nature of plain radiographs. The purpose of this study is to compare two accepted radiographic measurements, the hindfoot moment arm (HMA) and the hindfoot alignment angle (HAA), with a novel technique determining the ground reaction force calcaneal offset (GRF-CT) using 3- dimensional weight bearing CT Scans. Methods: Retrospective chart review was performed over a two-year period from 2014-2016 to identify patients with weight bearing hindfoot alignment radiographs and PedCat (Curvebeam, Warrington, USA) 3-D weight bearing CT scans. The HMA, HAA, and GRF-CT were measured by three different investigators. Each of these measurements were calculated two times on separate occasions by each investigator to determine the intra- and inter-observer reliability with each of these techniques Results: One-hundred and four patients underwent weight bearing hindfoot alignment radiographs and 3-dimensional weight bearing CT scans. There were 33 patients with varus deformities and 71 patients with valgus deformities. There was excellent intra- and inter-observer reliability with all three measurement techniques, however the GRF-CT showed the best intra- and inter-observer reliability with the lowest standard deviation Conclusion: The GRF-CT technique is more reliable than traditional radiograph techniques for measuring the hindfoot alignment. While the intra- and inter-observer reliability is good for all three techniques, the GRF-CT technique resulted in the best intra- and inter-observer reliability with the lowest standard deviation. This technique provides the most accurate hindfoot alignment as it takes into account the effect of forefoot on overall alignment, preventing inaccuracies of projection and foot orientation in contrast to traditional radiographic techniques, which may be valuable in surgical decision making.

A Robotic Ankle–Foot Prosthesis With Active Alignment

2016 ◽  
Vol 10 (2) ◽  
Author(s):  
Andrew Kennedy LaPrè ◽  
Brian R. Umberger ◽  
Frank C. Sup
Keyword(s):  
Center Of Pressure ◽  
Reaction Force ◽  
Residual Limb ◽  
Moment Arm ◽  
Ankle Prosthesis ◽  
Socket Connection ◽  
The Moment ◽  
Socket Interface ◽  
Configuration Changes ◽  
Large Moment

An ankle–foot prosthesis designed to mimic the missing physiological limb generates a large sagittal moment during push off which must be transferred to the residual limb through the socket connection. The large moment is correlated with high internal socket pressures that are often a source of discomfort for the person with amputation, limiting prosthesis use. In this paper, the concept of active alignment is developed. Active alignment realigns the affected residual limb toward the center of pressure (CoP) during stance. During gait, the prosthesis configuration changes to shorten the moment arm between the ground reaction force (GRF) and the residual limb. This reduces the peak moment transferred through the socket interface during late stance. A tethered robotic ankle prosthesis has been developed, and evaluation results are presented for active alignment during normal walking in a laboratory setting. Preliminary testing was performed with a subject without amputation walking with able-bodied adapters at a constant speed. The results show a 33% reduction in the peak resultant moment transferred at the socket limb interface.

scholarly journals A Forefoot Strike Requires the Highest Forces Applied to the Foot Among Foot Strike Patterns

2017 ◽  
Vol 01 (02) ◽  
pp. E37-E42 ◽  
Author(s):  
Satoru Hashizume ◽  
Toshio Yanagiya
Keyword(s):  
Achilles Tendon ◽  
Ground Reaction Force ◽  
Reaction Force ◽  
Moment Arm ◽  
Moment Arms ◽  
Joint Reaction Forces ◽  
Force Moment ◽  
Foot Strike ◽  
Reaction Forces ◽  
Joint Reaction

AbstractGround reaction force is often used to predict the potential risk of injuries but may not coincide with the forces applied to commonly injured regions of the foot. This study examined the forces applied to the foot, and the associated moment arms made by three foot strike patterns. 10 male runners ran barefoot along a runway at 3.3 m/s using forefoot, midfoot, and rearfoot strikes. The Achilles tendon and ground reaction force moment arms represented the shortest distance between the ankle joint axis and the line of action of each force. The Achilles tendon and joint reaction forces were calculated by solving equations of foot motion. The Achilles tendon and joint reaction forces were greatest for the forefoot strike (2 194 and 3 137 N), followed by the midfoot strike (1 929 and 2 853 N), and the rearfoot strike (1 526 and 2 394 N). The ground reaction force moment arm was greater for the forefoot strike than for the other foot strikes, and was greater for the midfoot strike than for the rearfoot strike. Meanwhile, there were no differences in the Achilles tendon moment arm among all foot strikes. These differences were attributed mainly to differences in the ground reaction force moment arm among the three foot strike patterns.

scholarly journals Biomechanical asymmetries persist after ACL reconstruction: results of a 2-year study

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Fatemeh Sharafoddin-Shirazi ◽  
Amir Letafatkar ◽  
Jennifer Hogg ◽  
Vahid Saatchian
Keyword(s):  
Ground Reaction Force ◽  
Reaction Force ◽  
Force Plate ◽  
Asymmetry Index ◽  
Knee Adduction Moment ◽  
Vertical Ground Reaction Force ◽  
Level Of Evidence ◽  
Post Surgery ◽  
Peak Knee ◽  
Flexion Moment

Abstract Purpose This study was aimed to examine longitudinal (6, 12, 18, 24 months) asymmetries in double-leg landing kinetics and kinematics of subjects with and without unilateral ACLR. Methods Three-dimensional kinematic and kinetic parameters of 40 participants (n = 20 post-ACLR, n = 20 healthy) were collected with a motion analysis system and force plate during a drop-landing task, and asymmetry indices were compared between groups. Results The asymmetry index (AI) in the ACLR group compared to the healthy group decreased from six to 24 months for vertical ground reaction force (vGRF) from 100% to 6.5% and for anterior posterior ground reaction force (a-pGRF) from 155.5% to 7%. Also, the AI decreased for peak hip flexion moment from 74.5% to 17.1%, peak knee flexion moment from 79.0% to 5.8% and peak ankle dorsiflexion moment from 59.3% to 5.9%. As a further matter, the AI decreased for peak hip abduction moment from 67.8% to 5.1%, peak knee adduction moment from 55.7% to 14.8% and peak knee valgus angle from 48.7% to 23.5%. Conclusions Results obtained from this longitudinal study showed that ACLR patients still suffer from limb asymmetries during landing tasks, which appear to normalize by 24-monthspost-surgery. This finding can help us to better understand biomechanics of the limbs after ACLR, and design more efficient post-surgery rehabilitation programs. Level of evidence Level III.

Estimation of ground reaction force from joint center positions during balance exergaming

2021 ◽  
Vol 90 ◽  
pp. 124
Author(s):  
E. Klæbo Vonstad ◽  
B. Vereijken ◽  
K. Bach ◽  
X. Su ◽  
J.H. Nilsen
Keyword(s):  
Ground Reaction Force ◽  
Reaction Force ◽  
Joint Center
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