Effect of foot and ankle immobilization on able-bodied gait as a model to increase understanding about bilateral transtibial amputee gait

2017 ◽  
Vol 41 (6) ◽  
pp. 556-563 ◽  
Author(s):  
Antonia Nepomuceno ◽  
Matthew J Major ◽  
Rebecca Stine ◽  
Steven Gard
Keyword(s):  
Power Generation ◽  
Range Of Motion ◽  
Foot And Ankle ◽  
Compensatory Mechanisms ◽  
Qualitative Comparison ◽  
Transtibial Amputation ◽  
Gait Quality ◽  
Lower Limb Prosthesis ◽  
And Function ◽  
Cast Condition

Background:The anatomical foot–ankle complex facilitates advancement of the stance limb through foot rockers and late-stance power generation during walking, but this mechanism is altered for persons with bilateral transtibial amputation when using passive prostheses.Objectives:To study the effects of bilateral foot and ankle immobilization on able-bodied gait to serve as a model for understanding gait of persons with bilateral transtibial amputation and associated compensatory mechanisms.Study design:Comparative analysis.Methods:Nine able-bodied persons walked at self-selected slow, normal, and fast speeds. They performed trials unaltered and when fitted with bilateral foot and ankle–immobilizing casts. Data from 10 individuals with bilateral transtibial amputation walking at self-selected fast speeds were used for qualitative comparison.Results:The average speeds for the able-bodied fast speed cast and normal speed no-cast trials were similar and were compared with bilateral transtibial amputation data. The able-bodied cast condition data more closely matched bilateral transtibial amputation data than the no-cast data. Ankle range-of-motion and power generation at pre-swing in the cast condition were markedly decreased, while trunk lateral flexion and transverse rotation range-of-motion and peak hip power generation increased.Conclusion:Results suggest that the absence of active ankle range-of-motion and power generation contributes to the development of characteristic compensatory gait mechanisms displayed by persons with bilateral transtibial amputation.Clinical relevanceThis study helps to improve understanding of compensatory mechanisms resulting from reduced foot and ankle joint motion to inform lower limb prosthesis design and function for improving gait quality of individuals with bilateral transtibial amputation.

scholarly journals Associations of foot and ankle characteristics with knee symptoms and function in individuals with patellofemoral osteoarthritis

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Jade M. Tan ◽  
Kay M. Crossley ◽  
Shannon E. Munteanu ◽  
Natalie J. Collins ◽  
Harvi F. Hart ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Knee Pain ◽  
Single Step ◽  
Ankle Dorsiflexion ◽  
Trial Registration ◽  
Patellofemoral Osteoarthritis ◽  
Foot And Ankle ◽  
Patient Reported ◽  
Foot Posture ◽  
And Function

Abstract Background Foot and ankle characteristics are associated with patellofemoral pain (PFP) and may also relate to patellofemoral osteoarthritis (PFOA). A greater understanding of these characteristics and PFOA, could help to identify effective targeted treatments. Objectives To determine whether foot and ankle characteristics are associated with knee symptoms and function in individuals with PFOA. Methods For this cross-sectional study we measured weightbearing ankle dorsiflexion range of motion, foot posture (via the Foot Posture Index [FPI]), and midfoot mobility (via the Foot Measurement Platform), and obtained patient-reported outcomes for knee symptoms and function (100 mm visual analogue scales, Anterior Knee Pain Scale [AKPS], Knee injury and Osteoarthritis Outcome Score, repeated single step-ups and double-leg sit-to-stand to knee pain onset). Pearson’s r with significance set at p < 0.05 was used to determine the association between foot and ankle charateristics, with knee symptoms and function, adjusting for age. Results 188 participants (126 [67%] women, mean [SD] age of 59.9 [7.1] years, BMI 29.3 [5.6] kg/m2) with symptomatic PFOA were included in this study. Lower weightbearing ankle dorsiflexion range of motion had a small significant association with higher average knee pain (partial r = − 0.272, p < 0.001) and maximum knee pain during stair ambulation (partial r = − 0.164, p = 0.028), and lower scores on the AKPS (indicative of greater disability; partial r = 0.151, p = 0.042). Higher FPI scores (indicating a more pronated foot posture) and greater midfoot mobility (foot mobility magnitude) were significantly associated with fewer repeated single step-ups (partial r = − 0.181, p = 0.023 and partial r = − 0.197, p = 0.009, respectively) and double-leg sit-to-stands (partial r = − 0.202, p = 0.022 and partial r = − 0.169, p = 0.045, respectively) to knee pain onset, although the magnitude of these relationships was small. The amount of variance in knee pain and disability explained by the foot and ankle characteristics was small (R2-squared 2 to 8%). Conclusions Lower weightbearing ankle dorsiflexion range of motion, a more pronated foot posture, and greater midfoot mobility demonstrated small associations with worse knee pain and greater disability in individuals with PFOA. Given the small magnitude of these relationships, it is unlikely that interventions aimed solely at addressing foot and ankle mobility will have substantial effects on knee symptoms and function in this population. Trial registration The RCT was prospectively registered on 15 March 2017 with the Australia and New Zealand Clinical Trials Registry (ANZCTRN12617000385347).

EFEITOS DO DEEP RUNNING SOBRE A AMPLITUDE DE MOVIMENTO E A CAPACIDADE FUNCIONAL DOS MEMBROS SUPERIORES DE MULHERES MASTECTOMIZADAS: RELATO DE CASOS

2019 ◽  
pp. 121-131
Keyword(s):  
Range Of Motion ◽  
Upper Limb ◽  
Functional Capacity ◽  
External Rotation ◽  
Treatment Protocol ◽  
Range Of Movement ◽  
Flexion Extension ◽  
Before And After ◽  
In The Beginning ◽  
And Function

Introduction: Breast cancer is the most common type of cancer among women in Brazil and in the worl. The surgical treatment procedure may cause severe morbidity in the upper limb homolateral to surgery, including the reduction of the range of motion, with consequent impairment of function. A physiotherapeutic approach has an important role in the recover range of motion and the functionality of these women, guaranteeing the occupational, domestestic, familiar and conjugated activities, and, in this way, also improving the quality of life. Objectives: To analyse chances in the shoulder's range of motion and the functional capacity of the upper limbs, promoted by the deep running procedure in women with late postoperative mastectomy. Methods: All the patients were submitted to an evaluation in the beginning and end of the treatment, including: goniometry of flexion, extension, abduction, adduction, internal and external rotation of the shoulder joint; and function capacity analysis in activities that involve the upper members by DASH questionnaire. The treatment protocol includes twelve sessions of deep running, realized twice a week, in deep pool, for 20-minute during six weeks. Results: Were submitted to treatment a total of 4 patients. Despite the improvement in the numerical values, statistically significant differences were not found on the range of movements and in the functional capacity of upper members before and after the deep running sessions in post-mastectomy women. Conclusion: Deep running had effects on the numerical values of range of movement and upper limb functionality in women in the late postoperative period of the mastectomy procedure, but without statistically significant differences.

Effect of Therapy Using Aquatic Treadmill on the Functional Status of Patients with Knee Arthrosis

2020 ◽  
Vol 62 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Agnieszka Maruszewska ◽  
Lech Panasiuk ◽  
Agnieszka Buczaj ◽  
Anna Pecyna
Keyword(s):  
Range Of Motion ◽  
Perceived Exertion ◽  
Treadmill Exercise ◽  
Exercise Programme ◽  
Locomotor System ◽  
Lequesne Index ◽  
Knee Arthrosis ◽  
Index Of Severity ◽  
And Function ◽  
Aquatic Treadmill

Introduction: Arthrosis is considered as a disease of the whole locomotor system, which may be prevented and treated at early stages. Gonarthrosis develops gradually within 10-15 years, interfering with daily activities and capability for work. Aquatic exercises are considered as a potentially effective therapeutic intervention in persons with knee arthrosis. Aim: Assessment of the effectiveness of a 4-week aquatic treadmill exercise programme, with respect to the measurement of pain, balance, function, and mobility. Materials and Methods: The study covered 15 patients with gonarthrosis, using a 4-week cycle of exercises. The results of measurements included a visual-analogue scale for assessing pain, Time Up and Go (TUG) for balance, 6-meter walk test for mobility and Lequesne index for function. The exercise protocol covered an aquatic treadmill using water jets to destabilize while standing, and achieve high ratings of perceived exertion during walking. Results: The comparison of results obtained by the patients after 20 interventions, with those obtained before therapy allowing the presumption that on the level of significance α= 0.05 there occurred statistically significant differences in the results of the tests performed (p<0.05). This concerned both pain complaints (VAS scale, Lequesne index of severity for arthrosis of the knee), as well as functional tests TUG, and measurement of the range of motion (p = 0.041-0.001). Conclusions: Based on the results of the study a decrease was observed in pain complaints, improvement of the range of motion in the joints, balance and function, after participation in a 4-week aquatic treadmill exercise programme, which contained the components of balance and endurance training.

scholarly journals Lateral open wedge calcaneus osteotomy with bony allograft augmentation in adult acquired flatfoot deformity. Clinical and radiological results

2021 ◽  
Author(s):  
Gabriele Colo’ ◽  
Mattia Alessio Mazzola ◽  
Giulio Pilone ◽  
Giacomo Dagnino ◽  
Lamberto Felli
Keyword(s):  
Range Of Motion ◽  
Case Series ◽  
Deformity Correction ◽  
Tibialis Posterior ◽  
Open Wedge ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Adult Acquired Flatfoot Deformity

Abstract The aim of this study is to evaluate the results of patients underwent lateral open wedge calcaneus osteotomy with bony allograft augmentation combined with tibialis posterior and tibialis anterior tenodesis. Twenty-two patients underwent adult-acquired flatfoot deformity were retrospectively evaluated with a minimum 2-year follow-up. Radiographic preoperative and final comparison of tibio-calcaneal angle, talo–first metatarsal and calcaneal pitch angles have been performed. The Visual Analog Scale, American Orthopedic Foot and Ankle Score, the Foot and Ankle Disability Index and the Foot and Ankle Ability Measure were used for subjective and functional assessment. The instrumental range of motion has been also assessed at latest follow-up evaluation and compared with preoperative value. There was a significant improvement of final mean values of clinical scores (p < 0.001). Nineteen out of 22 (86.4%) patients resulted very satisfied or satisfied for the clinical result. There was a significant improvement of the radiographic parameters (p < 0.001). There were no differences between preoperative and final values of range of motion. One failure occurred 7 years after surgery. Adult-acquired flatfoot deformity correction demonstrated good mid-term results and low recurrence and complications rate. Level of evidence Level 4, retrospective case series.

scholarly journals Evaluation of Ankle Mobility Loss in Patients Undergoing Subtalar Arthrodesis

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0011
Author(s):  
Tiago S. Baumfeld ◽  
Roberto Zambelli de A. Pinto ◽  
Fernando Araujo S. Lopes ◽  
Daniel Baumfeld ◽  
Camilo Tavares
Keyword(s):  
Range Of Motion ◽  
Plantar Flexion ◽  
Contralateral Side ◽  
Foot And Ankle ◽  
Lower Range ◽  
Open Chain ◽  
Subtalar Arthrodesis ◽  
Closed Chain ◽  
Ankle Mobility ◽  
Dorsal Flexion

Category: Hindfoot Introduction/Purpose: Objective: To evaluate and quantify the loss of ankle mobility in patients undergoing subtalar arthrodesis compared to the contralateral side, through physical examination. Methods: A total of 12 patients who had only the subtalar arthrodesis procedure from various causes in one foot were selected. The same foot and ankle surgeon performed all measurements of bilateral tibiotarsal range of motion, with loaded closed-chain and unloaded open-chain tests. Then, to assess whether there was a difference between the operated and the non-operated side, statistical analysis was performed with the Mann-Whitney test (Hollander and Wolfe 1999). Results: On the loaded closed-chain test, the operated side had a significantly lower range of motion than the contralateral side, with a mean difference of 5.4 degrees for dorsal flexion and 7.6 degrees for plantar flexion. The open-chain tests showed non- significant differences of 3 degrees for dorsal flexion and 5.3 degrees for plantar flexion. Conclusion: Subtalar joint arthrodesis was shown to cause a loss of mobility in the ipsilateral ankle, which is greater in plantar flexion movement.

Kinematic Design of Functional Nanoscale Mechanisms From Molecular Primitives

2021 ◽  
Author(s):  
Meysam T. Chorsi ◽  
Pouya Tavousi ◽  
Caitlyn Mundrane ◽  
Vitaliy Gorbatyuk ◽  
Kazem Kazerounian ◽  
...  
Keyword(s):  
Ion Channels ◽  
Range Of Motion ◽  
Systematic Approach ◽  
Design Space ◽  
Vital Role ◽  
Degree Of Freedom ◽  
Living Systems ◽  
Kinematic Design ◽  
Systematic Exploration ◽  
And Function

Abstract Natural nanomechanisms such as capillaries, neurotransmitters, and ion channels play a vital role in the living systems. But the design principles developed by nature through evolution are not well understood and, hence, not applicable to engineered nanomachines. Thus, the design of nanoscale mechanisms with prescribed functions remains a challenge. Here, we present a systematic approach based on established kinematics techniques to designing, analyzing, and controlling manufacturable nanomachines with prescribed mobility and function built from a finite but extendable number of available "molecular primitives." Our framework allows the systematic exploration of the design space of irreducibly simple nanomachines, built with prescribed motion specification by combining available nanocomponents into systems having constrained, and consequently controllable motions. We show that the proposed framework has allowed us to discover and verify a molecule in the form of a seven link, seven revolute (7R) close loop spatial linkage with mobility (degree of freedom) of one. Furthermore, our experiments exhibit the type and range of motion predicted by our simulations. Enhancing such a structure into functional nanomechanisms by exploiting and controlling their motions individually or as part of an ensemble could galvanize development of the multitude of engineering, scientific, medical, and consumer applications that can benefit from engineered nanomachines.

scholarly journals Superoxide Anion Production and Bioenergetic Profile in Young and Elderly Human Primary Myoblasts

2018 ◽  
Vol 2018 ◽  
pp. 1-16 ◽  
Author(s):  
Mariangela Marrone ◽  
Rita Maria Laura La Rovere ◽  
Simone Guarnieri ◽  
Ester Sara Di Filippo ◽  
Giovanni Monaco ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Oxidative Phosphorylation ◽  
Energy Demand ◽  
The Elderly ◽  
Compensatory Mechanisms ◽  
Superoxide Anion Production ◽  
Age Related ◽  
Primary Myoblasts ◽  
Production Variability ◽  
And Function

Sarcopenia is the age-related loss of skeletal muscle mass, strength, and function. It is associated with regenerative difficulties by satellite cells, adult muscle stem cells, and alteration of oxidative management, mainly the increase in superoxide anions (O2•−). We aimed to investigate the relation between regenerative deficit in elderly and increase in O2•− production along with mitochondrial alterations. Myoblasts and myotubes from skeletal muscle of young and elderly healthy subjects (27.8 ± 6 and 72.4 ± 6.5 years old) were measured: (1) superoxide dismutase activity and protein content, (2) mitochondrial O2•− production levels, (3) O2•− production variability, and (4) mitochondrial bioenergetic profile. Compared to young myoblasts, elderly myoblasts displayed decreased SOD2 protein expression, elevated mitochondrial O2•− baseline levels, and decreased oxidative phosphorylation and glycolysis. Additionally, elderly versus young myotubes showed elevated mitochondrial O2•− levels when stressed with N-acetyl cysteine or high glucose and higher glycolysis despite showing comparable oxidative phosphorylation levels. Altogether, the elderly may have less metabolic plasticity due to the impaired mitochondrial function caused by O2•−. However, the increased energy demand related to the differentiation process appears to activate compensatory mechanisms for the partial mitochondrial dysfunction.

A Mechanical Equinometer to Measure the Range of Motion of the Ankle Joint: Interobserver and Intraobserver Reliability

2006 ◽  
Vol 27 (3) ◽  
pp. 202-205 ◽  
Author(s):  
Dominik C. Meyer ◽  
Clement M.L. Werner ◽  
Tobias Wyss ◽  
Patrick Vienne
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Precise Measurement ◽  
Knee Extension ◽  
Measurement Tool ◽  
Foot And Ankle ◽  
Reliable Technique ◽  
Plantar Surface ◽  
Clinical Measurements ◽  
Very High

Background: Clinical measurement of passive dorsiflexion of the ankle joint is essential for the diagnosis of various pathologic conditions of the foot and ankle but is of unreliable precision with high interobserver variability in nonweightbearing tests. This work was designed to develop and test a precise, standardized, and reliable technique for measurement of passive and active ankle range of motion. Methods: The proposed measurement tool is composed of two mobile parallelograms, one attached to the tibia, the second one to the plantar surface of the foot. The parallelograms are connected with a hinge with an angular scale to measure the angle between the foot and tibia. Results: Interobserver correlation between clinical measure-ments for maximal passive foot dorsiflexion were 0.03 with knee extension and 0.38 with knee flexion, while for measurements with the proposed tool they reached 0.89 and 0.97, respectively, with a mean measurement error of 0.9 degrees. Intraobserver correlations reached values of r = 0.98 and 0.99. Conclusions: The proposed tool allows measurement of the ankle range of motion with very high precision and reproducibility far superior to clinical measurements. Clinical Relevance: Precise measurement of ankle range of motion is clinically challenging. With the use of the proposed tool, measurement precision and reliability are decisively improved.

Outcomes of the glove-gauze regimen for managing burn injuries of the hand

2020 ◽  
Vol 45 (7) ◽  
pp. 737-741
Author(s):  
Oleksandra Vyrva ◽  
Elliott Smock ◽  
Joel Pessa ◽  
Sunil M. Thirkannad
Keyword(s):  
Physical Therapy ◽  
Range Of Motion ◽  
Full Range ◽  
Effective Means ◽  
Healing Time ◽  
Full Thickness ◽  
Level Of Evidence ◽  
Partial Thickness ◽  
And Function ◽  
Hand Burns

We studied the efficacy of the glove-gauze regimen in treating superficial, partial-thickness and small full-thickness hand burns. Outcome measures included healing time, need for surgical intervention, need for formal physical therapy, restoration of range of motion, return to function and incidence of infection. All patients ( n = 123) successfully completed the regimen with an average healing time of 3.7 weeks. None required surgical debridement and seven (6%) required formal physical therapy. One hundred and eighteen patients (96%) regained full range of motion and 122 (99%) returned to their previous level of work. We believe that the glove-gauze regimen provides a simplified and effective means of managing hand burns. We conclude from our patients that the glove-gauze regimen is an effective treatment that can ensure uneventful healing of superficial, partial-thickness and small full-thickness burns. A majority of our patients healed with full range of motion and function without formal physical therapy. Level of evidence: IV

scholarly journals Genetic Analysis of Collagen Q: Roles in Acetylcholinesterase and Butyrylcholinesterase Assembly and in Synaptic Structure and Function

1999 ◽  
Vol 144 (6) ◽  
pp. 1349-1360 ◽  
Author(s):  
Guoping Feng ◽  
Eric Krejci ◽  
Jordi Molgo ◽  
Jeanette M. Cunningham ◽  
Jean Massoulié ◽  
...  
Keyword(s):  
Neuromuscular Junctions ◽  
Synaptic Cleft ◽  
Neuromuscular Function ◽  
Nerve Terminals ◽  
Compensatory Mechanisms ◽  
Structural Mechanism ◽  
Synaptic Structure ◽  
Cardiac Muscles ◽  
And Function ◽  
Early Phases

Acetylcholinesterase (AChE) occurs in both asymmetric forms, covalently associated with a collagenous subunit called Q (ColQ), and globular forms that may be either soluble or membrane associated. At the skeletal neuromuscular junction, asymmetric AChE is anchored to the basal lamina of the synaptic cleft, where it hydrolyzes acetylcholine to terminate synaptic transmission. AChE has also been hypothesized to play developmental roles in the nervous system, and ColQ is also expressed in some AChE-poor tissues. To seek roles of ColQ and AChE at synapses and elsewhere, we generated ColQ-deficient mutant mice. ColQ−/− mice completely lacked asymmetric AChE in skeletal and cardiac muscles and brain; they also lacked asymmetric forms of the AChE homologue, butyrylcholinesterase. Thus, products of the ColQ gene are required for assembly of all detectable asymmetric AChE and butyrylcholinesterase. Surprisingly, globular AChE tetramers were also absent from neonatal ColQ−/− muscles, suggesting a role for the ColQ gene in assembly or stabilization of AChE forms that do not themselves contain a collagenous subunit. Histochemical, immunohistochemical, toxicological, and electrophysiological assays all indicated absence of AChE at ColQ−/− neuromuscular junctions. Nonetheless, neuromuscular function was initially robust, demonstrating that AChE and ColQ do not play obligatory roles in early phases of synaptogenesis. Moreover, because acute inhibition of synaptic AChE is fatal to normal animals, there must be compensatory mechanisms in the mutant that allow the synapse to function in the chronic absence of AChE. One structural mechanism appears to be a partial ensheathment of nerve terminals by Schwann cells. Compensation was incomplete, however, as animals lacking ColQ and synaptic AChE failed to thrive and most died before they reached maturity.

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