scholarly journals Isolating the Energetic and Mechanical Consequences of Imposed Reductions in Ankle and Knee Flexion during Gait.

2021 ◽  
Author(s):  
Emily McCain ◽  
Theresa Libera ◽  
Matthew Berno ◽  
Gregory Sawicki ◽  
Katherine Saul ◽  
...  
Keyword(s):  
Metabolic Cost ◽  
Relative Increase ◽  
Joint Motion ◽  
Knee Motion ◽  
Ankle Motion ◽  
Gait Characteristics ◽  
Joint Range Of Motion ◽  
3D Printed ◽  
Ankle Function ◽  
Joint Range

Abstract Background: Weakness of ankle and knee musculature following injury or disorder results in reduced joint motion associated with metabolically expensive gait compensations to enable limb support and advancement. However, neuromechanical coupling between the ankle and knee make it difficult to discern independent roles of these restrictions in joint motion on compensatory mechanics and metabolic penalties.Methods: We sought to determine relative impacts of ankle and knee impairment on compensatory gait strategies and energetic outcomes using an unimpaired cohort (N=15) with imposed unilateral joint range of motion restrictions as a surrogate for reduced motion resulting from gait pathology. Participants walked on a dual-belt instrumented treadmill at 0.8 m s-1 using a 3D printed ankle stay and a knee brace to systematically limit ankle motion (restricted-ank), knee motion (restricted-knee), and ankle and knee motion (restricted-a+k) simultaneously. In addition, participants walked without any ankle or knee bracing (control) and with knee bracing worn but unrestricted (braced).Results: When ankle motion was restricted (restricted-ank, restricted-a+k) we observed decreased peak propulsion relative to the braced condition on the restricted limb. Reduced knee motion (restricted-knee, restricted-a+k) increased restricted limb circumduction relative to the restricted-ank condition through ipsilateral hip hiking. Interestingly, restricted limb average positive hip power increased in the restricted-ank condition but decreased in the restricted-a+k and restricted-knee conditions, suggesting that locking the knee impeded hip compensation. As expected, reduced ankle motion, either without (restricted-ank) or in addition to knee restriction (restricted-a+k) yielded significant increase in net metabolic rate when compared with the braced condition. Furthermore, the relative increase in metabolic cost was significantly larger with restricted-a+k when compared to restricted-knee condition.Conclusions: Our methods allowed for the reproduction of asymmetric gait characteristics including reduced propulsive symmetry and increased circumduction. The metabolic consequences bolster the potential energetic benefit of targeting ankle function during rehabilitation.

scholarly journals Isolating the energetic and mechanical consequences of imposed reductions in ankle and knee flexion during gait

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Emily M. McCain ◽  
Theresa L. Libera ◽  
Matthew E. Berno ◽  
Gregory S. Sawicki ◽  
Katherine R. Saul ◽  
...  
Keyword(s):  
Metabolic Cost ◽  
Relative Increase ◽  
Joint Motion ◽  
Knee Motion ◽  
Ankle Motion ◽  
Gait Characteristics ◽  
Joint Range Of Motion ◽  
3D Printed ◽  
Ankle Function ◽  
Joint Range

Abstract Background Weakness of ankle and knee musculature following injury or disorder results in reduced joint motion associated with metabolically expensive gait compensations to enable limb support and advancement. However, neuromechanical coupling between the ankle and knee make it difficult to discern independent roles of these restrictions in joint motion on compensatory mechanics and metabolic penalties. Methods We sought to determine relative impacts of ankle and knee impairment on compensatory gait strategies and energetic outcomes using an unimpaired cohort (N = 15) with imposed unilateral joint range of motion restrictions as a surrogate for reduced motion resulting from gait pathology. Participants walked on a dual-belt instrumented treadmill at 0.8 m s−1 using a 3D printed ankle stay and a knee brace to systematically limit ankle motion (restricted-ank), knee motion (restricted-knee), and ankle and knee motion (restricted-a + k) simultaneously. In addition, participants walked without any ankle or knee bracing (control) and with knee bracing worn but unrestricted (braced). Results When ankle motion was restricted (restricted-ank, restricted-a + k) we observed decreased peak propulsion relative to the braced condition on the restricted limb. Reduced knee motion (restricted-knee, restricted-a + k) increased restricted limb circumduction relative to the restricted-ank condition through ipsilateral hip hiking. Interestingly, restricted limb average positive hip power increased in the restricted-ank condition but decreased in the restricted-a + k and restricted-knee conditions, suggesting that locking the knee impeded hip compensation. As expected, reduced ankle motion, either without (restricted-ank) or in addition to knee restriction (restricted-a + k) yielded significant increase in net metabolic rate when compared with the braced condition. Furthermore, the relative increase in metabolic cost was significantly larger with restricted-a + k when compared to restricted-knee condition. Conclusions Our methods allowed for the reproduction of asymmetric gait characteristics including reduced propulsive symmetry and increased circumduction. The metabolic consequences bolster the potential energetic benefit of targeting ankle function during rehabilitation. Trial registration N/A.

scholarly journals Isolating the Energetic and Mechanical Consequences of Imposed Reductions in Ankle and Knee Flexion during Gait.

2020 ◽  
Author(s):  
Emily McCain ◽  
Theresa Libera ◽  
Matthew Berno ◽  
Gregory Sawicki ◽  
Katherine Saul ◽  
...  
Keyword(s):  
Metabolic Cost ◽  
Relative Increase ◽  
Joint Motion ◽  
Knee Motion ◽  
Ankle Motion ◽  
Gait Characteristics ◽  
Joint Range Of Motion ◽  
3D Printed ◽  
Ankle Function ◽  
Joint Range

Abstract Background: Weakness of ankle and knee musculature following injury or disorder results in reduced joint motion associated with metabolically expensive gait compensations to enable limb support and advancement. However, neuromechanical coupling between the ankle and knee make it difficult to discern independent roles of these restrictions in joint motion on compensatory mechanics and metabolic penalties.Methods: We sought to determine relative impacts of ankle and knee impairment on compensatory gait strategies and energetic outcomes using an unimpaired cohort (N=15) with imposed unilateral joint range of motion restrictions as a surrogate for reduced motion resulting from gait pathology. Participants walked on a dual-belt instrumented treadmill at 0.8 m s-1 using a 3D printed ankle stay and a knee brace to systematically limit ankle motion (restricted-ank), knee motion (restricted-knee), and ankle and knee motion (restricted-a+k) simultaneously. In addition, participants walked without any ankle or knee bracing (control) and with knee bracing worn but unrestricted (braced).Results: When ankle motion was restricted (restricted-ank, restricted-a+k) we observed decreased peak propulsion relative to the braced condition on the restricted limb. Reduced knee motion (restricted-knee, restricted-a+k) increased restricted limb circumduction relative to the restricted-ank condition through ipsilateral hip hiking. Interestingly, restricted limb average positive hip power increased in the restricted-ank condition but decreased in the restricted-a+k and restricted-knee conditions, suggesting that locking the knee impeded hip compensation. As expected, reduced ankle motion, either without (restricted-ank) or in addition to knee restriction (restricted-a+k) yielded significant increase in net metabolic rate when compared with the braced condition. Furthermore, the relative increase in metabolic cost was significantly larger with restricted-a+k when compared to restricted-knee condition.Conclusions: Our methods allowed for the reproduction of asymmetric gait characteristics including reduced propulsive symmetry and increased circumduction. The metabolic consequences bolster the potential energetic benefit of targeting ankle function during rehabilitation.

scholarly journals Isolating the Energetic and Mechanical Consequences of Imposed Reductions in Ankle and Knee Flexion during Gait.

2020 ◽  
Author(s):  
Emily McCain ◽  
Theresa Libera ◽  
Matthew Berno ◽  
Gregory Sawicki ◽  
Katherine Saul ◽  
...  
Keyword(s):  
Metabolic Cost ◽  
Relative Increase ◽  
Knee Motion ◽  
Ankle Motion ◽  
Gait Characteristics ◽  
Joint Range Of Motion ◽  
Locked Knee ◽  
3D Printed ◽  
Ankle Function ◽  
Joint Range

Abstract Background: Weakness of ankle and knee musculature following injury or disorder is associated with metabolically expensive gait compensations to enable limb support and advancement. However, neuromechanical coupling between the ankle and knee makes it difficult to discern independent roles of these joint dysfunctions on compensatory mechanics and metabolic penalties.Methods: We sought to determine relative impacts of ankle and knee impairment on compensatory gait strategies and energetic outcomes using an unimpaired cohort (N=15) with imposed unilateral joint range of motion restrictions as a surrogate for gait pathology. Participants walked on a dual-belt instrumented treadmill at 0.8 m s-1 using a 3D printed ankle stay and a knee brace to systematically limit ankle motion (locked-ank), knee motion (locked-knee), and ankle and knee motion (locked-a+k) simultaneously. In addition, participants walked without any ankle or knee bracing (control) and with knee bracing worn but unlocked (unlocked).Results: When ankle motion was restricted (locked-ank, locked-a+k) we observed decreased peak propulsion of the locked limb relative to unlocked. Reduced knee motion (locked-knee, locked-a+k) increased locked limb circumduction relative to the locked-ank condition through ipsilateral hip hiking. Interestingly, locked limb average positive hip power increased in the locked-ank condition but decreased in the locked-a+k and locked-knee conditions, suggesting that locking the knee impeded hip compensation. As expected, reduced ankle motion, either without (locked-ank) or in addition to knee restriction (locked-a+k) yielded significant increase in net metabolic rate when compared with unlocked. Furthermore, the relative increase in metabolic cost was significantly larger with locked-a+k when compared to locked-knee condition.Conclusions: Our methods allowed for the reproduction of asymmetric gait characteristics including reduced locked limb propulsion and increased circumduction. The metabolic consequences bolster the potential energetic benefit of targeting ankle function during rehabilitation.

Cinematographical Methods to Assess Associated Movements in Children

1989 ◽  
Vol 6 (3) ◽  
pp. 255-267 ◽  
Author(s):  
Emmie Hsu ◽  
Steve Bardfield ◽  
Bryant J. Cratty ◽  
Alan Garfinkel
Keyword(s):  
Pilot Study ◽  
High Speed ◽  
Phase Plane ◽  
Angular Displacement ◽  
Joint Motion ◽  
Kinematic Data ◽  
Joint Range Of Motion ◽  
Ankle Joints ◽  
Angular Displacements ◽  
Joint Range

This pilot study was conducted to test the usefulness of angle-angle diagrams and phase plane plots obtained through high-speed cinematographical methods for making graded assessments of associated movements in children. Kinematic data at the shoulder, elbow, and ankle joints of normal and motorically awkward children (5-7 years old) were obtained from digitized films of normal and heel walking trials on a motor driven treadmill. A computer program was developed to smooth, calculate, differentiate, and plot data. Angle-angle diagrams depicting simultaneous joint angular displacements of (a) shoulder versus ankle and (b) elbow versus ankle revealed graded differences in decoupling of joint motion, limb excursions, and joint range-of-motion changes between the 5-year-old, 7-year-old awkward, and 7-year-old normal subject. Phase planes of the shoulder, elbow, and ankle joint were obtained by plotting joint angular displacement against joint angular velocity. Differences in size, shape, and looping behavior showed the quantity of change and whether the changes were gradual or sudden. This noninvasive methodology and eventual standardization of angle-angle diagrams and phase planes could prove to be useful in providing more precise diagnoses of associated movements and other subtle movement disorders.

scholarly journals Hip and knee kinematics display complex and time-varying sagittal kinematics during repetitive stepping: Implications for design of a functional fatigue model of the knee extensors and flexors

2014 ◽  
Author(s):  
Corey Scholes ◽  
Michael McDonald ◽  
Anthony Parker
Keyword(s):  
Knee Kinematics ◽  
Test Reliability ◽  
Velocity Variation ◽  
Knee Extensors ◽  
Knee Motion ◽  
Functional Fatigue ◽  
Joint Range Of Motion ◽  
Fatigue Model ◽  
Joint Range ◽  
Flexion And Extension

The validity of fatigue protocols involving multi-joint movements, such as stepping, has yet to be clearly defined. Although surface electromyography can monitor the fatigue state of individual muscles, the effects of joint angle and velocity variation on signal parameters are well established. Therefore, the aims of this study were to i) describe sagittal hip and knee kinematics during repetitive stepping ii) identify periods of high inter-trial variability and iii) determine within-test reliability of hip and knee kinematic profiles. A group of healthy men (N = 15) ascended and descended from a knee-high platform wearing a weighted vest (10%BW) for 50 consecutive trials. The hip and knee underwent rapid flexion and extension during step ascent and descent. Variability of hip and knee velocity peaked between 20-40% of the ascent phase and 80-100% of the descent. Significant (p<0.05) reductions in joint range of motion and peak velocity during step ascent were observed, while peak flexion velocity increased during descent. Healthy individuals use complex hip and knee motion to negotiate a knee-high step with kinematic patterns varying across multiple repetitions. These findings have important implications for future studies intending to use repetitive stepping as a fatigue model for the knee extensors and flexors.

Measurement of finger joint motion after flexor tendon repair: smartphone photography compared with traditional goniometry

2021 ◽  
pp. 175319342199106
Author(s):  
Jing Chen ◽  
Ai Xian Zhang ◽  
Si Jia Qian ◽  
Yu Jing Wang
Keyword(s):  
Flexor Tendon ◽  
Interobserver Reliability ◽  
Tendon Repair ◽  
Correlation Coefficients ◽  
Joint Motion ◽  
Altman Analysis ◽  
Flexor Tendon Repair ◽  
Joint Range Of Motion ◽  
Interclass Correlation ◽  
Joint Range

The purpose of our study was to determine whether smartphone photography is as reliable and valid as clinical goniometry for measuring interphalangeal joint range of motion. We conducted a retrospective review of 37 fingers in 33 patients after flexor tendon repair. The measurements on photographs taken with a smartphone by a surgeon were compared with manual measurements with goniometry by the same surgeon. Pearson coefficients and interclass correlation coefficients were all above 0.85, and Bland–Altman analysis demonstrated that at least 35 of 37 measurements were within the 95% confidence interval in all variables. According to the Tang criteria, the total number of excellent and good results were equivalent according to both methods. There was high interobserver reliability between measurements by surgeons and a therapist. We conclude that if the pictures are properly taken, the measurement of the angles in the smartphone pictures are as reliable as measuring the angles with goniometry and that grading of the results according to the two methods gives identical results.

scholarly journals The 3D Printed Total Talus Replacement: A Novel Treatment Option for Avascular Necrosis of the Talus

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0027
Author(s):  
Rishin J. Kadakia ◽  
Craig C. Akoh ◽  
Jie Chen ◽  
Akhil Sharma ◽  
Selene G. Parekh
Keyword(s):  
Range Of Motion ◽  
Avascular Necrosis ◽  
Treatment Option ◽  
Patient Reported Outcomes ◽  
Disease Stage ◽  
Pain Scores ◽  
Joint Range Of Motion ◽  
Patient Reported ◽  
3D Printed ◽  
Joint Range

Category: Ankle; Trauma Introduction/Purpose: Talus avascular necrosis (AVN) is a challenging entity to treat. Management options depend upon disease stage and severity. Total talus replacement (TTR) is a treatment option that maintains joint range of motion. The literature on TTR is limited with variability in implant design and material. The purpose of this study is to evaluate outcomes following total talus replacement with a custom 3D printed metal implant. Methods: Patients that underwent TTR were retrospectively reviewed over a three year period. Basic demographic data and comorbidities were collected. Medical records were reviewed to obtain postoperative and preoperative visual analog (VAS) scores, Foot and Ankle Outcomes Scores, (FAOS), ankle range of motion, and postoperative complications. Statistical analysis was conducted to compare clinical and patient-reported outcomes pre and postoperatively. Results: Twenty-eight patients underwent TTR for talar AVN with a mean follow-up of 16.4 months. Ankle range of motion remained unchanged statistically pre and postoperatively. VAS pain scores improved significantly pre and postoperative from 6.6 to 3.9 (p < 0.001). FAOS scores significantly improved postoperatively with regards to pain (p = 0.002), symptoms (p=0.03), quality of life (p < 0.001), and activities of daily living (P < 0.001). There were three complications requiring reoperation in this cohort. Conclusion:: 3D printed total talus replacements represent a unique surgical option for patients with talar collapse secondary to AVN. Patients in this cohort demonstrated significant improvements in pain scores and patient-reported outcomes while maintaining preoperative joint range of motion. TTR allows for symptomatic improvement with the preservation of motion in individuals with talar collapse and end-stage AVN.

scholarly journals Concurrent Validity of Equine Joint Range of Motion Measurement: A Novel Digital Goniometer versus Universal Goniometer

Animals ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 2436
Author(s):  
Anna Bergh ◽  
Nicole Gandre Lauridsen ◽  
Amie Lamoreaux Hesbach
Keyword(s):  
Range Of Motion ◽  
Concurrent Validity ◽  
Intraclass Correlation ◽  
Joint Motion ◽  
The Novel ◽  
Joint Angles ◽  
User Friendliness ◽  
Joint Range Of Motion ◽  
Simple Tool ◽  
Joint Range

Goniometry is the measurement of joint angles with a conventional universal goniometer (UG) or a digital goniometer (DG). The UG is validated for use in dogs and cats. However, it demands both of the user’s hands when measuring. To avoid this, a novel type of DG has been developed, simplifying measurement by offering single-hand usage. The objective of this study is to examine the concurrent validity of the DG. The study consists of measurement with the DG and UG for flexion of the carpus and fetlock on ten horses, and with the DG in flexion and neutral positioning of the fetlock on a sedated horse and corresponding radiographs, intra- and inter-tester reliability and a survey on user-friendliness. The data were analyzed with ANOVA and intraclass correlation coefficient (ICC), with a significance of p < 0.05. The study showed significant differences in range of motion for the carpus and fetlock joint, a 2–3° difference comparing measurements on a sedated horse with corresponding radiographs, a “fair” to “excellent” inter-tester reliability and a “fair” to “almost perfect” intra-tester reliability, and the DG was easier to use than the UG. In conclusion, the novel DG may serve as a simple tool for measuring joint motion in equine rehabilitation patients.

Arthroscopy in Arthrosis: Is It Worth it? A case Presentation

2018 ◽  
Vol 69 (8) ◽  
pp. 2232-2235
Author(s):  
Marius Moga ◽  
Mark Edward Pogarasteanu ◽  
Antoine Edu
Keyword(s):  
Clinical Status ◽  
Loose Body ◽  
Point Of View ◽  
The Other ◽  
Joint Range Of Motion ◽  
Objective Evidence ◽  
Before And After ◽  
Total Knee ◽  
Joint Range

The role of arthroscopy in incipient and mild arthrosis, even combined with proximal tibial ostetomy, is well known and well documented. On the other hand, its role in the treatment of advanced arthrosis of the large joints, especially the knee, is a subject of controversy. The proponents of the use of arthroscopy in advanced arthrosis claim that meniscectomy, synovectomy, ostophytectomy, chondral lesion stabilization, arthroscopic release, plica and loose body removal greatly improve the quality of life for most patients, especially if followed by the use of viscoelastic injection, by diminishing pain and improving joint range of motion. The opponents claim that, even though the advantages are clear in the cases that refuse arthroplasty, in all the other cases the surgical indication should be total knee arthroplasty, as the clinical relief is temporary, but with all the risks of a surgical intervention. We have conducted an overview of the recent literature, in order to find objective evidence to sustain either point of view. We focused on articles published that included an objective measurement of before and after clinical status through clinical scores and objective measurements. We also focused on the follow-up period and on the evolution of the pathology after arthroscopy.

scholarly journals Limitations of Foot-Worn Sensors for Assessing Running Power

Sensors ◽  
2021 ◽  
Vol 21 (15) ◽  
pp. 4952
Author(s):  
Tobias Baumgartner ◽  
Steffen Held ◽  
Stefanie Klatt ◽  
Lars Donath
Keyword(s):  
Time Use ◽  
Stride Length ◽  
Metabolic Cost ◽  
Running Economy ◽  
Accelerometer Data ◽  
Gait Characteristics ◽  
Significant Difference ◽  
Metabolic Costs ◽  
Ground Contact Time ◽  
Training Signal

Running power as measured by foot-worn sensors is considered to be associated with the metabolic cost of running. In this study, we show that running economy needs to be taken into account when deriving metabolic cost from accelerometer data. We administered an experiment in which 32 experienced participants (age = 28 ± 7 years, weekly running distance = 51 ± 24 km) ran at a constant speed with modified spatiotemporal gait characteristics (stride length, ground contact time, use of arms). We recorded both their metabolic costs of transportation, as well as running power, as measured by a Stryd sensor. Purposely varying the running style impacts the running economy and leads to significant differences in the metabolic cost of running (p < 0.01). At the same time, the expected rise in running power does not follow this change, and there is a significant difference in the relation between metabolic cost and power (p < 0.001). These results stand in contrast to the previously reported link between metabolic and mechanical running characteristics estimated by foot-worn sensors. This casts doubt on the feasibility of measuring running power in the field, as well as using it as a training signal.

Sign in / Sign up

Export Citation Format

Share Document