Evaluation of Ankle Mobility Loss in Patients Undergoing Subtalar Arthrodesis

Objective: To evaluate and quantify, through physical examination, loss of ankle mobility in patients undergoing subtalar fusion, in comparison to the contralateral side. Methods: A total of 12 patients who underwent unilateral isolated subtalar arthrodesis for different conditions were selected. The assessment was performed with the aid of a goniometer, measurements of the bilateral range of motion of the tibiotarsal joint, in closed chain weight-bearing and open chain non-weight-bearing. The same foot and ankle surgeon performed all measurements. Results: The operated side achieved significantly lower range of motion values in the closed chain weight-bearing test compared to the contralateral side, with a mean difference of 5.4° (p=0.029) for dorsiflexion and 7.6° (p=0.006) for plantar flexion. No statistically significant difference was found in the open chain test. Conclusion: Isolated subtalar joint arthrodesis leads to reduced range of motion in the ipsilateral ankle. Level of Evidence III; Therapeutic Study; Comparative Retrospective Study.

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Manual Therapy Versus Closed Kinematic Exercises—The Influence on the Range of Movement in Patients with Knee Osteoarthritis: A Pilot Study

Applied Sciences ◽

10.3390/app10238605 ◽

2020 ◽

Vol 10 (23) ◽

pp. 8605

Author(s):

Krystyna Hejdysz ◽

Jagoda Goślińska ◽

Agnieszka Wareńczak ◽

Joanna Dudzińska ◽

Ewa Adamczyk ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Range Of Motion ◽

Manual Therapy ◽

Negative Impact ◽

Therapy Group ◽

Exercise Group ◽

Control Group ◽

Range Of Movement ◽

Open Chain ◽

Closed Chain

Reduced range of motion is one of the main symptoms of knee osteoarthritis. These deficits are believed to have a negative impact on activities of daily living. The aim of the study was to examine how manual therapy and closed-chain kinematic exercises affect the range of motion in patients with knee osteoarthritis. Sixty-six patients with knee osteoarthritis were recruited and divided into three groups: manual therapy group, exercise group, and control group. The following parameters were evaluated before and after 10 days of rehabilitation: the range of motion in the open and closed kinematic chain using Orthyo sensors, pain intensity using Visual Analogue Scale (VAS), and the subjective functional assessment in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The results indicate an increase in the range of motion after manual therapy in the open chain test and an increase in the possible range of motion in the closed chain test in the exercise group. Both study groups showed significant improvement of WOMAC-assessed function and a significant decrease of VAS-assessed pain following rehabilitation. Manual therapy and exercise affect the range of motion in patients with knee osteoarthritis. When examining the range of motion, it is worth taking into account various biomechanical conditions.

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Design of Eight-Bar Linkages With an Application to Rectilinear Motion

Volume 5B: 39th Mechanisms and Robotics Conference ◽

10.1115/detc2015-47804 ◽

2015 ◽

Author(s):

Kaustubh H. Sonawale ◽

J. Michael McCarthy

Keyword(s):

Range Of Motion ◽

Kinematic Analysis ◽

Random Search ◽

Rectilinear Motion ◽

Open Chain ◽

Closed Chain ◽

Systematic Selection ◽

Forward Kinematic ◽

And Control ◽

Selection Of

This paper explores an automated methodology to design eight-bar linkages for five positions, by constraining the user defined 4R open chain and 6R closed chain using RR dyads. The application in focus is that of rectilinear motion. The paper lays down the rules for systematic selection of link pairs for the application of RR constraints, that help automate the synthesis of eight-bar linkages. The methodology performs a random search within the user specified tolerance zones around the task specifications to increase the number of candidate linkage solutions. These linkages are then subjected to forward kinematic analysis using the Dixon determinant elimination procedure to find all possible linkage configurations over the range of motion of the input link. Linkages that have all the task configurations on one branch ensure their smooth movement through them. The result is an array of defect-free eight-bars that can perform approximate rectilinear motion. This method provides increased flexibility and control over the synthesized linkage compared to other known rectilinear motion linkages, owing to the ability to specify the backbone chain. A couple of examples are presented to illustrate the results.

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Intrinsic factors associated with medial tibial stress syndrome in athletes: A large case-control study

South African Journal of Sports Medicine ◽

10.17159/2078-516x/2013/v25i3a353 ◽

2013 ◽

Vol 25 (3) ◽

pp. 63 ◽

Cited By ~ 1

Author(s):

M Winters ◽

H Veldt ◽

EW Bakker ◽

MH Moen

Keyword(s):

Risk Factors ◽

Range Of Motion ◽

Plantar Flexion ◽

Large Population ◽

Multivariate Logistic Regression Analysis ◽

Medial Tibial Stress Syndrome ◽

Stress Syndrome ◽

Hip Abduction ◽

Ankle Plantar Flexion ◽

Dorsal Flexion

Background. Medial tibial stress syndrome (MTSS) is the most common lower-leg injury in athletes, and is thought to be caused by bony overload. To prevent MTSS, both pathophysiological and aetiological factors specific to MTSS need to be identified. The intrinsic risk factors that contribute to the development of MTSS are still uncertain.Objective. To determine the intrinsic risk factors of MTSS by sampling a large population of athletic MTSS patients and controls.Methods. Athletes with MTSS and control subjects were medically examined in terms of range of motion of the leg joints (hip abduction, adduction, internal and external range of motion; ankle plantar and dorsal flexion; hallux extension and flexion; subtalar inversion and eversion), measures of over-pronation and maximal calf girth.Results. Ninety-seven subjects agreed to participate in the study: 48 MTSS patients and 49 active controls. The following variables were considered: gender, age, body mass index (BMI), hip abduction, hip adduction, internal and external hip range of rotation, ankle plantar and dorsal flexion, hallux flexion and extension, subtalar inversion and eversion, maximal calf girth, standing foot angle and navicular drop test. In multivariate logistic regression analysis, hip abduction (odds ratio (OR) 0.82; 95% confidence interval (CI) 0.72 - 0.94), ankle plantar flexion (OR 0.73; 95% CI 0.61 - 0.87) and subtalar inversion (OR 1.24; 95% CI 1.10 - 1.41) were significantly associated with MTSS. The Nagelkerke R2 for this model was 0.76, indicating that 76% of the variance in the presence of MTSS could be explained by these variables.Conclusion. Decreased hip abduction, decreased ankle plantar flexion and an increased subtalar inversion could be considered risk factors for MTSS.

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Intrinsic factors associated with medial tibial stress syndrome in athletes: A large case-control study

South African Journal of Sports Medicine ◽

10.17159/2413-3108/2013/v25i3a353 ◽

2013 ◽

Vol 25 (3) ◽

pp. 63

Author(s):

M Winters ◽

H Veldt ◽

EW Bakker ◽

MH Moen

Keyword(s):

Risk Factors ◽

Range Of Motion ◽

Plantar Flexion ◽

Large Population ◽

Multivariate Logistic Regression Analysis ◽

Medial Tibial Stress Syndrome ◽

Stress Syndrome ◽

Hip Abduction ◽

Ankle Plantar Flexion ◽

Dorsal Flexion

Background. Medial tibial stress syndrome (MTSS) is the most common lower-leg injury in athletes, and is thought to be caused by bony overload. To prevent MTSS, both pathophysiological and aetiological factors specific to MTSS need to be identified. The intrinsic risk factors that contribute to the development of MTSS are still uncertain.Objective. To determine the intrinsic risk factors of MTSS by sampling a large population of athletic MTSS patients and controls.Methods. Athletes with MTSS and control subjects were medically examined in terms of range of motion of the leg joints (hip abduction, adduction, internal and external range of motion; ankle plantar and dorsal flexion; hallux extension and flexion; subtalar inversion and eversion), measures of over-pronation and maximal calf girth.Results. Ninety-seven subjects agreed to participate in the study: 48 MTSS patients and 49 active controls. The following variables were considered: gender, age, body mass index (BMI), hip abduction, hip adduction, internal and external hip range of rotation, ankle plantar and dorsal flexion, hallux flexion and extension, subtalar inversion and eversion, maximal calf girth, standing foot angle and navicular drop test. In multivariate logistic regression analysis, hip abduction (odds ratio (OR) 0.82; 95% confidence interval (CI) 0.72 - 0.94), ankle plantar flexion (OR 0.73; 95% CI 0.61 - 0.87) and subtalar inversion (OR 1.24; 95% CI 1.10 - 1.41) were significantly associated with MTSS. The Nagelkerke R2 for this model was 0.76, indicating that 76% of the variance in the presence of MTSS could be explained by these variables.Conclusion. Decreased hip abduction, decreased ankle plantar flexion and an increased subtalar inversion could be considered risk factors for MTSS.

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Asymmetry of the active nonweightbearing foot and ankle range of motion for dorsiflexion-plantar flexion and its coupled movements in adults

Clinical Anatomy ◽

10.1002/ca.20512 ◽

2007 ◽

Vol 20 (7) ◽

pp. 834-842 ◽

Cited By ~ 6

Author(s):

Virgilio F. Ferrario ◽

Michela Turci ◽

Nicola Lovecchio ◽

Yuri F. Shirai ◽

Chiarella Sforza

Keyword(s):

Range Of Motion ◽

Plantar Flexion ◽

Foot And Ankle

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Comparison of the Plantar Pressure and Foot Function and Range of Motion in Distance Runners With the Normal, Pronated, and Supinated Feet During Static Standing

Journal of Modern Rehabilitation ◽

10.32598/jmr.15.1.3 ◽

2020 ◽

Vol 15 (1) ◽

pp. 15-24

Author(s):

Navid Keivanfar ◽

Azadeh Shadmehr ◽

Khadijeh Otadi ◽

Seyed Mohsen Mir ◽

Saman Salehi

Keyword(s):

Range Of Motion ◽

Contact Area ◽

Plantar Pressure ◽

Plantar Flexion ◽

Foot And Ankle ◽

Distance Runners ◽

Cross Sectional ◽

Foot Posture ◽

Foot Function ◽

The Mean

Introduction: This study aimed to investigate the foot function, range of motion, plantar pressure, and plantar contact area in the distance runners with normal, pronated, highly-pronated, supinated, and highly-supinated foot posture groups during static standing.Materials and Methods: In this comparative cross-sectional study, a total of 75 distance runners were divided into 5 groups using the foot posture index. The foot function and knee and foot range of motion were assessed using the Foot And Ankle Ability Measure questionnaire (FAAM) and the goniometer, respectively. The mean of the plantar pressure percentage and the mean of the contact area on the forefoot and rearfoot were investigated during static standing. One-way ANOVA was used to compare the outcomes between the groups.Results: Among the groups, the normal foot group showed the highest scores in the activities of daily living subscale and sport subscale. Compared with the other groups, the highly-pronated foot group had a significantly greater range of motion in the ankle plantar flexion (P<0.002), and the normal foot group showed more range of motion in the first metatarsophalangeal extension (P<0.0001). In all groups, the mean plantar pressure percentage on the rearfoot was greater than the mean plantar pressure percentage on the forefoot. Of the groups, the highly-supinated foot group showed the highest plantar pressure percentage on the rearfoot (P<0.0001). However, the highly-pronated foot group showed the highest plantar pressure percentage and the largest contact area on the forefoot (P<0.0001) and the rearfoot (P>0.0001), respectively.Conclusion: Based on the results of this study, the foot posture is an important option that could affect function and range of motion of foot and ankle and distribution of the plantar pressure and plantar contact area.

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Evaluation of Results of Extraperiosteal Plating of Pronation-Abduction Ankle Fractures in Adults

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v19i2.50039 ◽

2020 ◽

Vol 19 (2) ◽

pp. 32-36

Author(s):

Tafhim Ehsan Kabir ◽

Salehuddin Ahmad ◽

Alak Kanti Biswas

Keyword(s):

Range Of Motion ◽

Ankle Fracture ◽

Plantar Flexion ◽

Deep Infection ◽

Ankle Fractures ◽

Foot And Ankle ◽

Superficial Infection ◽

Adult Age ◽

Fibular Fracture ◽

American Orthopaedic

Background: Pronation-abduction ankle fractures frequently are associated with substantial lateral comminution and is associated with the highest rates of nonunion among indirect ankle fractures. It is one of the common injuries occurring in adult age group where trauma is the main etiology. The present prospective hospital based observational study was conducted to evaluate the functional outcome of treatment of ankle fracture by extraperiosteal plating in a series of patients with pronation-abduction ankle fractures. Materials and methods : A total of 30 consecutive patients aged over 18 years with pronation-abduction ankle fracture were included in the study and underwent surgery by extraperiosteal plating of the fibular fracture. Patients were selected irrespective of sex. The average age of the patients was 36.5 years. Patients with gustilo type III open fractures, pathological fractures were excluded from the study. The patients were evaluated functionally with the use of the American Orthopaedic Foot and Ankle Society score (AOFAS) radiographically, and clinically with range of motion testing. Results: Immediate postoperative and final follow-up radiographs showed that most of the patients had a well-aligned ankle mortise on the fractured side as compared with the normal side on the basis of standardized measurements. All fractures healed without displacement. The average American Orthopaedic Foot and Ankle Society score was 81.5. The range of motion averaged 13° of dorsiflexion and 53° of plantar flexion. Satisfactory results were obtained in 93.33 % patients. Complication includes 2(6.66%) superficial infection, 1(3.33%) deep infection, 4(13.33%) delayed union, 1(3.33%) skin necrosis. Radiological evaluation revealed persistent of talar shift in 1(3.33%) patient postoperatively. Conclusions: Extraperiosteal plating to be an effective method for the stabilization of pronation-abduction ankle fractures. The technique allows for accurate reduction of the mortise without stripping the periosteum of the comminuted region of the fracture. The technique is easier and faster than standard techniques in which the lateral periosteum is split to facilitate placement of the plate. Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 32-36

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Reliability of Bi-Axial Ankle Stiffness Measurement in Older Adults

Sensors ◽

10.3390/s21041162 ◽

2021 ◽

Vol 21 (4) ◽

pp. 1162

Author(s):

Hogene Kim ◽

Sangwoo Cho ◽

Hwiyoung Lee

Keyword(s):

Older Adults ◽

Range Of Motion ◽

Angular Displacement ◽

Plantar Flexion ◽

Significant Negative Correlation ◽

Talocrural Joint ◽

Ankle Foot Orthosis ◽

Ankle Stiffness ◽

Ankle Movement ◽

Test Retest Reliability

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.

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

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-021-02888-3 ◽

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.

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