scholarly journals Hindfoot motion analysis by subtalar compensation and ankle osteoarthritis stage using a multi-segment foot model

2021 ◽  
Author(s):  
Ho Won Kang ◽  
Dae-Yoo Kim ◽  
Gil-Young Park ◽  
Jung Min Kim ◽  
Dong-Oh Lee ◽  
...  
Keyword(s):  
Medical Records ◽  
Subtalar Joint ◽  
Three Dimensional ◽  
Step Width ◽  
Ankle Osteoarthritis ◽  
Hindfoot Alignment ◽  
Gait Parameters ◽  
Compensation Methods ◽  
Spatiotemporal Parameters ◽  
Foot Model

Abstract Background The biomechanics of the hindfoot in ankle osteoarthritis (OA) are not yet fully understood. Here we aimed to identify hindfoot motion in a gait analysis using a multi-segment foot model (MFM) according to ankle OA stage or hindfoot alignment by the presence of subtalar compensation. Methods We retrospectively reviewed the medical records, simple radiographs, and gait MFM data of 54 ankles admitted to our hospital for the treatment of advanced ankle OA. Spatiotemporal gait parameters and three-dimensional motions of the hindfoot segment were analyzed according to sex, age, body mass index, Takakura classification, and presence of subtalar compensation. Results No spatiotemporal gait parameters differed significantly according to the presence of subtalar compensation or ankle OA stage. Only normalized step width differed significantly (P = .028). Average hindfoot motion (decompensation versus compensation) did not differ significantly between the sagittal and transverse planes. Graphing of the coronal movement of the hindfoot revealed collapsed curves in both groups that differed significantly. Compared with Takakura stages 3a, 3b, and 4, cases of more advanced stage 3b had a smaller sagittal range of motion than those of stage 3a (P = .028). Coronal movement of the hindfoot in cases of Takakura stage 3a/3b/4 showed a relatively flat pattern. Conclusions The spatiotemporal parameters were not affected by the alignment state of the heel resulting from subtalar compensation. The sagittal range of hindfoot motion decreased in patients with advanced ankle OA. Once disrupted, the coronal movement of the subtalar joint in ankle OA did not change regardless of ankle OA stage or hindfoot compensation state.

Three-Dimensional In Vivo Kinematics of the Subtalar Joint During Dorsi-Plantarflexion and Inversion-Eversion

2009 ◽  
Vol 30 (05) ◽  
pp. 432-438 ◽  
Author(s):  
Akira Goto ◽  
Hisao Moritomo ◽  
Tomonobu Itohara ◽  
Tetsu Watanabe ◽  
Kazuomi Sugamoto
Keyword(s):  
Subtalar Joint ◽  
Three Dimensional ◽  
In Vivo Kinematics ◽  
And Inversion

scholarly journals Independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ramon J. Boekesteijn ◽  
José M. H. Smolders ◽  
Vincent J. J. F. Busch ◽  
Alexander C. H. Geurts ◽  
Katrijn Smulders
Keyword(s):  
Dual Task ◽  
Wearable Sensors ◽  
Body Motion ◽  
Effect Sizes ◽  
Upper Body ◽  
Healthy Controls ◽  
Gait Parameters ◽  
Dual Task Cost ◽  
Dual Task Performance ◽  
Spatiotemporal Parameters

Abstract Background Although it is well-established that osteoarthritis (OA) impairs daily-life gait, objective gait assessments are not part of routine clinical evaluation. Wearable inertial sensors provide an easily accessible and fast way to routinely evaluate gait quality in clinical settings. However, during these assessments, more complex and meaningful aspects of daily-life gait, including turning, dual-task performance, and upper body motion, are often overlooked. The aim of this study was therefore to investigate turning, dual-task performance, and upper body motion in individuals with knee or hip OA in addition to more commonly assessed spatiotemporal gait parameters using wearable sensors. Methods Gait was compared between individuals with unilateral knee (n = 25) or hip OA (n = 26) scheduled for joint replacement, and healthy controls (n = 27). For 2 min, participants walked back and forth along a 6-m trajectory making 180° turns, with and without a secondary cognitive task. Gait parameters were collected using 4 inertial measurement units on the feet and trunk. To test if dual-task gait, turning, and upper body motion had added value above spatiotemporal parameters, a factor analysis was conducted. Effect sizes were computed as standardized mean difference between OA groups and healthy controls to identify parameters from these gait domains that were sensitive to knee or hip OA. Results Four independent domains of gait were obtained: speed-spatial, speed-temporal, dual-task cost, and upper body motion. Turning parameters constituted a gait domain together with cadence. From the domains that were obtained, stride length (speed-spatial) and cadence (speed-temporal) had the strongest effect sizes for both knee and hip OA. Upper body motion (lumbar sagittal range of motion), showed a strong effect size when comparing hip OA with healthy controls. Parameters reflecting dual-task cost were not sensitive to knee or hip OA. Conclusions Besides more commonly reported spatiotemporal parameters, only upper body motion provided non-redundant and sensitive parameters representing gait adaptations in individuals with hip OA. Turning parameters were sensitive to knee and hip OA, but were not independent from speed-related gait parameters. Dual-task parameters had limited additional value for evaluating gait in knee and hip OA, although dual-task cost constituted a separate gait domain. Future steps should include testing responsiveness of these gait domains to interventions aiming to improve mobility.

The Subtalar Joint Axis Locator

2006 ◽  
Vol 96 (3) ◽  
pp. 212-219 ◽  
Author(s):  
Simon K. Spooner ◽  
Kevin A. Kirby
Keyword(s):  
Subtalar Joint ◽  
Dynamic Capabilities ◽  
Three Dimensional ◽  
Spatial Location ◽  
Exit Point ◽  
Neck Position ◽  
Dorsal Aspect ◽  
Joint Axis ◽  
Preliminary Study ◽  
Rotational Motions

A new clinical device, the subtalar joint axis locator, was created to track the three-dimensional location of the subtalar joint axis during weightbearing movements of the foot. The assumption was that if the anterior exit point of the subtalar joint axis is stationary relative to the dorsal aspect of the talar neck, then, by performing radiographs of the feet with the subtalar joint axis locator in place on the foot, the ability of the locator to track rotations and translations of the talar neck and thus the subtalar joint axis in space could be approximated. In this preliminary study of two adults, the subtalar joint axis locator accurately tracked the talar neck position during weightbearing rotational motions of the subtalar joint. The device was also used in a series of subjects to determine its dynamic capabilities. It is possible, then, that the subtalar joint axis locator can reliably track the spatial location of the subtalar joint axis during weightbearing movements of the foot. (J Am Podiatr Med Assoc 96(3): 212–219, 2006)

Center of Pressure Trajectory and Spatiotemporal Gait Parameters When Walking with Limited Knee Flexion

2021 ◽  
Vol 65 (1) ◽  
pp. 1490-1493
Author(s):  
Seobin Choi ◽  
Jieon Lee ◽  
Gwanseob Shin
Keyword(s):  
Knee Flexion ◽  
Stance Phase ◽  
Center Of Pressure ◽  
Dynamic Balance ◽  
Left Knee ◽  
Step Width ◽  
Normal Walking ◽  
Gait Stability ◽  
Gait Parameters ◽  
Stiff Knee

Stiff-knee, which indicates reduced range of knee flexion, may decrease gait stability. Although it is closely related to an increase in fall risk, the effect of limited knee flexion on the balance capacity during walking has not been well studied. This study aimed at examining how walking with limited knee flexion would influence the center of pressure (COP) trajectory and spatiotemporal gait parameters. Sixteen healthy young participants conducted four different walking conditions: normal walking and walking with limited knee flexion of their left knee up to 40 and 20 degrees, respectively. Results show that the participants walked significantly (p<0.05) slower with shorter stride length, wider step width, less cadence, and decreased stance phase when walking with limited knee flexion, compared to normal walking. The increase in the asymmetry and variability of the COP was also observed. It indicates that limited knee flexion during walking might affect the dynamic balance.

scholarly journals The effects of ankle-foot orthoses with plantar flexion stop and plantar flexion resistance using rocker-sole shoes on stroke gait: A randomized-controlled trial

2021 ◽  
Vol 67 (4) ◽  
pp. 449-461
Author(s):  
Aliyeh Daryabor ◽  
Gholamreza Aminian ◽  
Mokhtar Arazpour ◽  
Mina Baniasad ◽  
Sumiko Yamamoto
Keyword(s):  
Controlled Trial ◽  
Plantar Flexion ◽  
Three Dimensional ◽  
Chronic Phase ◽  
Controlled Study ◽  
Foot Orthoses ◽  
Randomized Controlled ◽  
Ankle Foot Orthoses ◽  
Spatiotemporal Parameters ◽  
Single Support Phase

Objectives: This study aims to evaluate the effect of two ankle-foot orthoses (AFOs), AFO with plantar flexion stop (AFO-PlfS), and AFO with plantar flexion resistance (AFO-PlfR), while wearing standard shoes and rocker-sole shoes. Patients and methods: Between November 2017 and July 2018, in this randomized-controlled study, a total of 20 stroke patients (8 males, 12 females; mean age: 48.1 years; range, 33 to 65 years) in chronic phase were randomized to AFO groups (AFO-PlfS group, n=10 and AFO-PlfR group, n=10). Each group received the allocated AFO along with two kinds of shoes (standard shoe and rocker shoe) for a two-week adaptation. Two effects were separately evaluated: The orthotic effect and rocker shoe effect were defined as the evaluation of using an AFO wearing standard shoe compared to only standard shoe, and evaluation of using an AFO wearing rocker shoe compared to an AFO wearing standard shoe, respectively. The gait of each group was measured by three-dimensional motion analysis. Results: A significant orthotic effect was found in both AFO groups in spatiotemporal parameters and maximum ankle dorsiflexion in the single-support phase. Additionally, the AFO-PlfR group showed a significant improvement in the parameters related to the first rocker of gait, but not for AFO-PlfS group concerning the orthotic effect. The rocker shoe effect was found in significant reduction of peak ankle plantar flexor moment and power ankle generation during preswing for both AFO groups. Conclusion: According to the orthotic effect, an AFO-PlfR can create better function in the improvement of parameters related to the first rocker. Although a rocker shoe can facilitate rollover for weight progression in the third rocker of gait, it cannot make a strong push-off function in stroke survivors.

scholarly journals Effect of wearing diapers on toddler’s gait

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tomoya Ueda ◽  
Haruna Asano ◽  
Kyoko Tsuge ◽  
Kanako Seo ◽  
Motoki Sudo ◽  
...  
Keyword(s):  
Motor Development ◽  
Joint Angle ◽  
Step Length ◽  
Step Width ◽  
Lower Stress ◽  
Gait Patterns ◽  
Bulk Stress ◽  
Joint Dynamics ◽  
Spatiotemporal Parameters ◽  
High Bulk

AbstractGait maturation in infants develops gradually through several phases. However, external factors such as childrearing practices, especially the wearing of diapers, may affect an infant’s motor development. This study investigated the influence of different bulk stresses on the gait of toddlers wearing a disposable diaper. Twenty-six healthy toddlers (age: 19.2 ± 0.9 months) participated in this study. We measured the joint kinematics (pelvis angle and hip-joint angle) and spatiotemporal parameters (step length and step width) of the toddlers’ gait under four dress conditions (wearing Type A_WET, Type A_DRY, and Type B_WET diapers and naked). Type B_WET had a higher bulk stress than Type A_WET, and Type A_DRY had lower stress than Type A _ WET. Our results indicate that the walk of toddlers when wearing a diaper differs from that when naked. This difference is due to the effect of the bulk of the diaper on the lower limb. A high bulk stress has a greater influence than that of a low bulk stress on joint dynamics and step width. Therefore, our findings suggest that wearing diapers with high bulk stress may inhibit the natural gait patterns of toddlers.

scholarly journals Effects of selectively assisting impaired subtasks of walking in chronic stroke survivors

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Simone S. Fricke ◽  
Hilde J. G. Smits ◽  
Cristina Bayón ◽  
Jaap H. Buurke ◽  
Herman van der Kooij ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Step Length ◽  
Gait Training ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
Baseline Trial ◽  
Gait Parameters ◽  
Flexion Extension ◽  
Spatiotemporal Parameters ◽  
Length Width

Abstract Background Recently developed controllers for robot-assisted gait training allow for the adjustment of assistance for specific subtasks (i.e. specific joints and intervals of the gait cycle that are related to common impairments after stroke). However, not much is known about possible interactions between subtasks and a better understanding of this can help to optimize (manual or automatic) assistance tuning in the future. In this study, we assessed the effect of separately assisting three commonly impaired subtasks after stroke: foot clearance (FC, knee flexion/extension during swing), stability during stance (SS, knee flexion/extension during stance) and weight shift (WS, lateral pelvis movement). For each of the assisted subtasks, we determined the influence on the performance of the respective subtask, and possible effects on other subtasks of walking and spatiotemporal gait parameters. Methods The robotic assistance for the FC, SS and WS subtasks was assessed in nine mildly impaired chronic stroke survivors while walking in the LOPES II gait trainer. Seven trials were performed for each participant in a randomized order: six trials in which either 20% or 80% of assistance was provided for each of the selected subtasks, and one baseline trial where the participant did not receive subtask-specific assistance. The influence of the assistance on performances (errors compared to reference trajectories) for the assisted subtasks and other subtasks of walking as well as spatiotemporal parameters (step length, width and height, swing and stance time) was analyzed. Results Performances for the impaired subtasks (FC, SS and WS) improved significantly when assistance was applied for the respective subtask. Although WS performance improved when assisting this subtask, participants were not shifting their weight well towards the paretic leg. On a group level, not many effects on other subtasks and spatiotemporal parameters were found. Still, performance for the leading limb angle subtask improved significantly resulting in a larger step length when applying FC assistance. Conclusion FC and SS assistance leads to clear improvements in performance for the respective subtask, while our WS assistance needs further improvement. As effects of the assistance were mainly confined to the assisted subtasks, tuning of FC, SS and WS can be done simultaneously. Our findings suggest that there may be no need for specific, time-intensive tuning protocols (e.g. tuning subtasks after each other) in mildly impaired stroke survivors.

scholarly journals Outcomes of Tibiotalocalcaneal Arthrodesis using a Custom Three-Dimensional Printed Titanium Truss Implant

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0017
Author(s):  
Daniel Corr ◽  
Jared Raikin ◽  
Joseph T. O’Neil ◽  
Steven M. Raikin
Keyword(s):  
Postoperative Complications ◽  
Short Form ◽  
Three Dimensional ◽  
Functional Improvement ◽  
Salvage Procedure ◽  
Foot And Ankle ◽  
Hindfoot Alignment ◽  
Average Patient ◽  
Osseous Defects

Category: Ankle; Hindfoot Introduction/Purpose: Tibiotalocalcaneal (TTC) arthrodesis (fusion) is considered a salvage procedure for patients with severe hindfoot and ankle pathology. Several techniques have been described for TTC fusion, including the use of an intramedullary rod, plate and screw constructs, screws only, and external fixation/frames. Recently, 3D printing technology has allowed for a new technique to treat large hindfoot and ankle osseous defects with a custom three-dimensional (3D) titanium truss implant. These implants are specifically designed based on preoperative patient computed tomography (CT) scans. Early studies have shown promising radiographic and functional results, though these have been limited largely to expert opinions and case reports. The purpose of this study is to evaluate the clinical, radiographic, and functional outcomes of TTC arthrodesis using a custom 3D titanium truss implant. Methods: A retrospective review of patients who have undergone TTC arthrodesis utilizing a custom 3D-printed titanium truss implant (4WEB Medical, Inc., Frisco, TX) with a fellowship-trained orthopaedic foot and ankle surgeon at a single institution was performed. Patients <18 years old, and those undergoing TTC arthrodesis using any other primary method of filling osseous defects (i.e. femoral head allografts, autografts) were excluded. Patient demographics including age, sex, body mass index (BMI), smoking status, laterality of surgery, co-morbidities (diabetes mellitus, rheumatoid arthritis), preoperative diagnosis, previous hindfoot or ankle surgeries, and any postoperative complications were collected. Patients at least one year removed from the procedure were contacted to complete the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) subscale, along with the Visual Analog Scale for pain (VAS) and the Short Form-12 questionnaire (SF-12). Postoperative radiographs were reviewed to assess ankle and hindfoot alignment, implant integrity and any osseous abnormalities. Results: Eighteen patients underwent TTC fusion using custom titanium truss implants and were eligible for follow-up and analysis. Average patient age at the time of surgery was 58.7 years, and average BMI was 30.25 kg/m2. Seven patients (38.9%) were either current or former smokers, and 3 patients (16.7%) were diabetic. On average, patient FAAM ADL scores improved from 33.23 preoperatively to 59.56 (p=0.023), while VAS pain scores decreased from 59.07 to 34.22 (p<0.001). SF-12 Mental Health scores increased from 45.45 to 56.42 (p=0.031), while Physical Health scores improved mildly from 28.78 to 31.75 (p=0.110). Two patients (11.1%) had significant postoperative complications; one patient went on to require below knee amputation, and one patient demonstrated incomplete healing with implant loosening at their most recent follow-up. Conclusion: We have shown that custom titanium truss implants are viable and effective for use in TTC fusion. Use of such implants resulted in significant functional improvement among the cohort with low rates of complications and subsequent surgical interventions.

Rear Foot Inversion/Eversion During Gait Relative to the Subtalar Joint Neutral Position

1996 ◽  
Vol 17 (7) ◽  
pp. 406-412 ◽  
Author(s):  
Michael Raymond Pierrynowski ◽  
Steve Barry Smith
Keyword(s):  
Subtalar Joint ◽  
Three Dimensional ◽  
Neutral Position ◽  
Foot Care ◽  
Worst Case ◽  
Foot Motion ◽  
Rear Part ◽  
Valid Estimate ◽  
Foot Position ◽  
Foot Orthotic

Clinicians often fabricate foot orthotic devices at the subtalar joint neutral position (STNP) to mimic the position of the rear foot during midstance. However, rear foot motion during gait, relative to the resting standing foot position, not the STNP, is often reported in the literature. The motion of the rear foot relative to a valid estimate of the STNP is unknown. In this study, six experienced foot care specialists manually placed the rear part of the feet of nine subjects at the STNP seven or eight times to obtain a valid estimate of each subject's STNP. The worst-case mean and 95% confidence interval of the STNP estimate for any one subject was 0.0° ± 0.7°. These nine subjects then walked on a motor-driven treadmill, set at 0.89 meters/sec, and three-dimensional estimates of each subject's rear foot inversion/eversion motion were obtained, then averaged over 6 to 26 strides. For most subjects, the rear foot was always everted during stance with mean and standard deviation maximal eversion (7.2° ± 1.2°) occurring at 44% of the total gait cycle. The inversion/eversion orientation during swing was characterized by 1 ° to 2° of eversion, with a small amount of inversion in early swing. These findings have implications for the fabrication of foot orthoses, since the rear foot is rarely near the STNP during stance.

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