Design of a manual device to measure ankle joint stiffness and range of motion

2011 ◽  
Vol 35 (4) ◽  
pp. 478-481 ◽  
Author(s):  
Toshiki Kobayashi ◽  
Aaron KL Leung ◽  
Stephen W Hutchins

Background and Aim: Ankle joint stiffness and its range of motion (ROM) are commonly assessed to determine the appropriate mechanical characteristics required in an effective ankle-foot orthosis (AFO) prescription. The aim of this technical note is to present the design of a manual device that enables their convenient measurement in the clinical setting and to demonstrate its reliability.Technique: The manual device was designed with a torquemeter, a potentiometer, a steering wheel, a rotary plate, and a foot plate. The measurement of resistive torque at 0° (neutral), 5° (dorsiflexion) and 10° (dorsiflexion) ankle angular positions demonstrated the high reliability of the device with Intraclass Correlation Coefficient (ICC) (1,k) values over 0.97.Discussion: Quantitative measurement of ankle joint stiffness and ROM by this manual device would provide objective information that could potentially assist AFO prescriptions. A future study should investigate how to incorporate the measurement obtained from the device into the prescription of an AFO.

2010 ◽  
Vol 34 (4) ◽  
pp. 439-448 ◽  
Author(s):  
Toshiki Kobayashi ◽  
Aaron k. L. Leung ◽  
Yasushi Akazawa ◽  
Hisashi Naito ◽  
Masao Tanaka ◽  
...  

The purpose of this study was to design a new automated stiffness measurement device which could perform a simultaneous measurement of both dorsi- and plantarflexion angles and the corresponding resistive torque around the rotational centre of an articulated ankle-foot orthosis (AAFO). This was achieved by controlling angular velocities and range of motion in the sagittal plane. The device consisted of a hydraulic servo fatigue testing machine, a torque meter, a potentiometer, a rotary plate and an upright supporter to enable an AAFO to be attached to the device via a surrogate shank. The accuracy of the device in reproducing the range of motion and angular velocity was within 4% and 1% respectively in the range of motion of 30&dG (15&dG plantarflexion to 15&dG dorsiflexion) at the angular velocity of 10&dG /s, while that in the measurement of AAFO torque was within 8% at the 0&dG position. The device should prove useful to assist an orthotist or a manufacturer to quantify the stiffness of an AAFO and inform its clinical use.


PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9687
Author(s):  
Vanina Costa ◽  
Óscar Ramírez ◽  
Abraham Otero ◽  
Daniel Muñoz-García ◽  
Sandra Uribarri ◽  
...  

Background Elbow and wrist chronic conditions are very common among musculoskeletal problems. These painful conditions affect muscle function, which ultimately leads to a decrease in the joint’s Range Of Motion (ROM). Due to their portability and ease of use, goniometers are still the most widespread tool for measuring ROM. Inertial sensors are emerging as a digital, low-cost and accurate alternative. However, whereas inertial sensors are commonly used in research studies, due to the lack of information about their validity and reliability, they are not widely used in the clinical practice. The goal of this study is to assess the validity and intra-inter-rater reliability of inertial sensors for measuring active ROM of the elbow and wrist. Materials and Methods Measures were taken simultaneously with inertial sensors (Werium™ system) and a universal goniometer. The process involved two physiotherapists (“rater A” and “rater B”) and an engineer responsible for the technical issues. Twenty-nine asymptomatic subjects were assessed individually in two sessions separated by 48 h. The procedure was repeated by rater A followed by rater B with random order. Three repetitions of each active movement (elbow flexion, pronation, and supination; and wrist flexion, extension, radial deviation and ulnar deviation) were executed starting from the neutral position until the ROM end-feel; that is, until ROM reached its maximum due to be stopped by the anatomy. The coefficient of determination (r2) and the Intraclass Correlation Coefficient (ICC) were calculated to assess the intra-rater and inter-rater reliability. The Standard Error of the Measurement and the Minimum Detectable Change and a Bland–Altman plots were also calculated. Results Similar ROM values when measured with both instruments were obtained for the elbow (maximum difference of 3° for all the movements) and wrist (maximum difference of 1° for all the movements). These values were within the normal range when compared to literature studies. The concurrent validity analysis for all the movements yielded ICC values ≥0.78 for the elbow and ≥0.95 for the wrist. Concerning reliability, the ICC values denoted a high reliability of inertial sensors for all the different movements. In the case of the elbow, intra-rater and inter-rater reliability ICC values range from 0.83 to 0.96 and from 0.94 to 0.97, respectively. Intra-rater analysis of the wrist yielded ICC values between 0.81 and 0.93, while the ICC values for the inter-rater analysis range from 0.93 to 0.99. Conclusions Inertial sensors are a valid and reliable tool for measuring elbow and wrist active ROM. Particularly noteworthy is their high inter-rater reliability, often questioned in measurement tools. The lowest reliability is observed in elbow prono-supination, probably due to skin artifacts. Based on these results and their advantages, inertial sensors can be considered a valid assessment tool for wrist and elbow ROM.


2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Fan-Zhe Low ◽  
Hong Han Tan ◽  
Jeong Hoon Lim ◽  
Chen-Hua Yeow

Deep vein thrombosis (DVT) is a severe medical condition that affects many patients around the world, where one of the main causes is commonly associated with prolonged immobilization. Current mechanical prophylaxis systems, such as the compression stockings and intermittent pneumatic compression devices, have yet to show strong efficacy in preventing DVT. The current study aimed to develop a soft pneumatic sock prototype that uses soft extension pneumatic actuators to provide assisted ankle dorsiflexion–plantarflexion motion, so as to prevent the occurrence of DVT. The prototype was evaluated for its efficacy to provide the required dorsiflexion–plantarflexion motion by donning and actuating the prototype on simulated ankle–foot models with various ankle joint stiffness values. Our results showed that the soft extension actuators in the sock prototype provided controllable assisted ankle plantarflexion through actuator extension and ankle dorsiflexion through actuator contraction, where in our study, the actuations extended to 129.9–146.8% of its original length. Furthermore, the sock was able to achieve consistent range of motion at the simulated ankle joint across different joint stiffness values (range of motion: 27.5 ± 6.0 deg). This study demonstrated the feasibility of using soft extension pneumatic actuators to provide robot-assisted ankle dorsiflexion–plantarflexion motion, which will act as an adjunct to physiotherapists to optimize therapy time for bedridden patients and therefore may reduce the risk of developing DVT.


Author(s):  
Karen Rodriguez ◽  
Jurriaan de Groot ◽  
Frank Baas ◽  
Marjon Stijntjes ◽  
Frans van der Helm ◽  
...  

2019 ◽  
Vol 109 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Motaz Abdalla Alawna ◽  
Bayram H. Unver ◽  
Ertugrul O. Yuksel

Background: Evaluation of range of motion (ROM) is integral to assessment of the musculoskeletal system, is required in health fitness and pathologic conditions, and is used as an objective outcome measure. Several methods are described to check ROM, each with advantages and disadvantages. Hence, this study introduces a new device using a smartphone goniometer to measure ankle joint ROM. Objective: To test the reliability of smartphone goniometry in the ankle joint by comparing it with the universal goniometer (UG) and to assess interrater and intrarater reliability for the smartphone goniometer record (SGR) application. Methods: Fifty-eight healthy volunteers (29 men and 29 women aged 18–30 years) underwent SGR and UG measurement of ankle joint dorsiflexion and plantarflexion. Two examiners measured ankle joint ROM. Descriptive statistics were calculated for descriptive and anthropometric variables, as were intraclass correlation coefficients (ICCs). Results: There were 58 usable data sets. For measuring ankle dorsiflexion ROM, both instruments showed excellent interrater reliability: UG (ICC = 0.87) and SGR (ICC = 0.89). Intrarater reliability was excellent in both instruments in ankle dorsiflexion: UG and SGR (mean ICC = 0.91). For measuring ankle plantarflexion, both instruments showed excellent interrater reliability: UG (ICC = 0.76) and SGR (ICC = 0.82). Intrarater reliability was excellent in both instruments in ankle plantarflexion: UG (mean ICC = 0.85) and SGR (mean ICC = 0.82). Conclusions: Smartphone-based goniometers can be used to assess active ROM of the ankle joint because they can achieve a high degree of intrarater and interrater reliability.


2021 ◽  
Vol 11 (11) ◽  
pp. 1512
Author(s):  
Yusuke Sekiguchi ◽  
Keita Honda ◽  
Dai Owaki ◽  
Shin-Ichi Izumi

Categorization based on quasi-joint stiffness (QJS) may help clinicians select appropriate ankle foot orthoses (AFOs). The objectives of the present study were to classify the gait pattern based on ankle joint stiffness, also called QJS, of the gait in patients after stroke and to clarify differences in the type of AFO among 72 patients after stroke. Hierarchical cluster analysis was used to classify gait patterns based on QJS at least one month before the study, which revealed three distinct subgroups (SGs 1, 2, and 3). The proportion of use of AFOs, articulated AFOs, and non-articulated AFOs were significantly different among SGs 1–3. In SG1, with a higher QJS in the early and middle stance, the proportion of the patients using articulated AFOs was higher, whereas in SG3, with a lower QJS in both stances, the proportion of patients using non-articulated AFOs was higher. In SG2, with a lower QJS in the early stance and higher QJS in the middle stance, the proportion of patients using AFOs was lower. These findings indicate that classification of gait patterns based on QJS in patients after stroke may be helpful in selecting AFO. However, large sample sizes are required to confirm these results.


2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Victor Prost ◽  
Kathryn M. Olesnavage ◽  
W. Brett Johnson ◽  
Matthew J. Major ◽  
Amos G. Winter

An experimental prosthetic foot intended for evaluating a novel design objective is presented. This objective, called the lower leg trajectory error (LLTE), enables the optimization of passive prosthetic feet by modeling the trajectory of the shank during single support for a given prosthetic foot and selecting design variables that minimize the error between this trajectory and able-bodied kinematics. A light-weight, fully characterized test foot with variable ankle joint stiffness was designed to evaluate the LLTE. The test foot can replicate the range of motion of a physiological ankle over a range of different ankle joint stiffnesses. The test foot consists of a rotational ankle joint machined from acetal resin, interchangeable U-shaped nylon springs that range from 1.5 N · m/deg to 24 N · m/deg, and a flexible nylon forefoot with a bending stiffness of 16 N · m2. The U-shaped springs were designed to support a constant moment along their length to maximize strain energy density; this feature was critical in creating a high-stiffness and high-range of motion ankle. The design performed as predicted during mechanical and in vivo testing, and its modularity allowed us to rapidly vary the ankle joint stiffness. Qualitative feedback from preliminary testing showed that this design is ready for use in large scale clinical trials to further evaluate the use of the LLTE as an optimization objective for passive prosthetic feet.


2019 ◽  
Vol 19 (06) ◽  
pp. 1950050
Author(s):  
M. T. KARIMI ◽  
R. B. TAHMASEBI ◽  
B. SATVATI ◽  
F. FATOYE

Flat foot is the most common foot disorder that influences the alignment of the lower limb structure. It is controversial whether the use of foot insole influences kinetic and kinematic of the leg or not. Therefore, this study investigated the influence of foot insole on the gait performance in subjects with flat foot disorder. A group of flat foot subject was recruited into this study (the number of subjects was 15). The motion of the leg joints was determined using the Qualysis motion analysis system. Moreover, the force applied on the lower limb was recorded by a Kistler force plate. The range of motion of the lower limb joints, the moments applied on the lower limb joints and force transmitted through the leg were the parameters used in this study. The difference between these parameters during walking with and without insole was evaluated using the paired [Formula: see text]-test. Significant value was set at [Formula: see text]. There was no significant difference between the range of motion of ankle joint while walking with and without insole. However, the medial directed force applied on the leg decreased significantly [Formula: see text]. The use of foot insole did not influence the moments transmitted through the hip and knee joints. The walking speed of the subjects improved while walking with foot insole. Use of foot insole influenced the magnitude of the force applied on the leg and the adductor moment of ankle joint due to its influence on foot alignment. As the walking speed of the improved subjects follows the use of insole, it can be concluded that it may have a positive effects on the performance of flat foot subjects.


Sensors ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 1162
Author(s):  
Hogene Kim ◽  
Sangwoo Cho ◽  
Hwiyoung Lee

This study involves measurements of bi-axial ankle stiffness in older adults, where the ankle joint is passively moved along the talocrural and subtalar joints using a custom ankle movement trainer. A total of 15 elderly individuals participated in test–retest reliability measurements of bi-axial ankle stiffness at exactly one-week intervals for validation of the angular displacement in the device. The ankle’s range of motion was also compared, along with its stiffness. The kinematic measurements significantly corresponded to results from a marker-based motion capture system (dorsi-/plantar flexion: r = 0.996; inversion/eversion: r = 0.985). Bi-axial ankle stiffness measurements showed significant intra-class correlations (ICCs) between the two visits for all ankle movements at slower (2.14°/s, ICC = 0.712) and faster (9.77°/s, ICC = 0.879) speeds. Stiffness measurements along the talocrural joint were thus shown to have significant negative correlation with active ankle range of motion (r = −0.631, p = 0.012). The ankle movement trainer, based on anatomical characteristics, was thus used to demonstrate valid and reliable bi-axial ankle stiffness measurements for movements along the talocrural and subtalar joint axes. Reliable measurements of ankle stiffness may help clinicians and researchers when designing and fabricating ankle-foot orthosis for people with upper-motor neuron disorders, such as stroke.


Author(s):  
Marcos A Soriano ◽  
G Gregory Haff ◽  
Paul Comfort ◽  
Francisco J Amaro-Gahete ◽  
Antonio Torres-González ◽  
...  

The aims of this study were to (I) determine the differences and relationship between the overhead press and split jerk performance in athletes involved in weightlifting training, and (II) explore the magnitude of these differences in one-repetition maximum (1RM) performances between sexes. Sixty-one men (age: 30.4 ± 6.7 years; height: 1.8 ± 0.5 m; body mass 82.5 ± 8.5 kg; weightlifting training experience: 3.7 ± 3.5 yrs) and 21 women (age: 29.5 ± 5.2 yrs; height: 1.7 ± 0.5 m; body mass: 62.6 ± 5.7 kg; weightlifting training experience: 3.0 ± 1.5 yrs) participated. The 1RM performance of the overhead press and split jerk were assessed for all participants, with the overhead press assessed on two occasions to determine between-session reliability. The intraclass correlation coefficients (ICC) and 95% confidence intervals showed a high reliability for the overhead press ICC = 0.98 (0.97 – 0.99). A very strong correlation and significant differences were found between the overhead press and split jerk 1RM performances for all participants (r = 0.90 [0.93 – 0.85], 60.2 ± 18.3 kg, 95.7 ± 29.3 kg, p ≤ 0.001). Men demonstrated stronger correlations between the overhead press and split jerk 1RM performances (r = 0.83 [0.73-0.90], p ≤ 0.001) compared with women (r = 0.56 [0.17-0.80], p = 0.008). These results provide evidence that 1RM performance of the overhead press and split jerk performance are highly related, highlighting the importance of upper-limb strength in the split jerk maximum performance.


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