scholarly journals Static Range of Motion of the First Metatarsal in the Sagittal and Frontal Planes

2018 ◽  
Vol 7 (11) ◽  
pp. 456 ◽  
Author(s):  
Sandra Tavara-Vidalón ◽  
Manuel Monge-Vera ◽  
Guillermo Lafuente-Sotillos ◽  
Gabriel Domínguez-Maldonado ◽  
Pedro Munuera-Martínez
Keyword(s):  
Range Of Motion ◽  
Least Squares Method ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Neutral Position ◽  
Future Design ◽  
First Metatarsal ◽  
Medial Cuneiform ◽  
First Ray ◽  
Degree Equation

The first metatarsal and medial cuneiform form an important functional unit in the foot, called “first ray”. The first ray normal range of motion (ROM) is difficult to quantify due to the number of joints that are involved. Several methods have previously been proposed. Controversy exists related to normal movement of the first ray frontal plane accompanying that in the sagittal plane. The objective of this study was to investigate the ROM of the first ray in the sagittal and frontal planes in normal feet. Anterior-posterior radiographs were done of the feet of 40 healthy participants with the first ray in a neutral position, maximally dorsiflexed and maximally plantarflexed. They were digitalized and the distance between the tibial malleolus and the intersesamoid crest in the three positions mentioned was measured. The rotation of the first ray in these three positions was measured. A polynomic function that fits a curve describing the movement observed in the first ray was obtained using the least squares method. ROM of the first ray in the sagittal plane was 6.47 (SD 2.59) mm of dorsiflexion and 6.12 (SD 2.55) mm of plantarflexion. ROM in the frontal plane was 2.69 (SD 4.03) degrees of inversion during the dorsiflexion and 2.97 (SD 2.72) degrees during the plantarflexion. A second-degree equation was obtained, which represents the movement of the first ray. Passive dorsiflexion and plantarflexion of the first ray were accompanied by movements in the frontal plane: 0.45 degrees of movement were produced in the frontal plane for each millimeter of displacement in the sagittal plane. These findings might be useful for the future design of instruments for clinically quantifying first ray mobility.

scholarly journals DOES BRAIN ACTIVATION DURING FUNCTIONAL MOVEMENT TASKS DIFFERENTIATE BETWEEN GOOD AND BAD MOVERS? AN INTEGRATED NEUROIMAGING ASSESSMENT OF MOTOR CONTROL IN YOUNG ATHLETES

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0013
Author(s):  
Manish Anand ◽  
Jed A. Diekfuss ◽  
Dustin R. Grooms ◽  
Alexis B. Slutsky-Ganesh ◽  
Scott Bonnette ◽  
...  
Keyword(s):  
Motor Control ◽  
Range Of Motion ◽  
Brain Function ◽  
Sagittal Plane ◽  
Brain Activity ◽  
Frontal Plane ◽  
Acl Injury ◽  
Timing Error ◽  
Lingual Gyrus ◽  
Increased Activity

Background: Aberrant frontal and sagittal plane knee motor control biomechanics contribute to increased anterior cruciate ligament (ACL) injury risk. Emergent data further indicates alterations in brain function may underlie ACL injury high risk biomechanics and primary injury. However, technical limitations have limited our ability to assess direct linkages between maladaptive biomechanics and brain function. Hypothesis/Purpose: (1) Increased frontal plane knee range of motion would associate with altered brain activity in regions important for sensorimotor control and (2) increased sagittal plane knee motor control timing error would associate with altered activity in sensorimotor control brain regions. Methods: Eighteen female high-school basketball and volleyball players (14.7 ± 1.4 years, 169.5 ± 7 cm, 65.8 ± 20.5 kg) underwent brain functional magnetic resonance imaging (fMRI) while performing a bilateral, combined hip, knee, and ankle flexion/extension movements against resistance (i.e., leg press) Figure 1(a). The participants completed this task to a reference beat of 1.2 Hz during four movement blocks of 30 seconds each interleaved in between 5 rest blocks of 30 seconds each. Concurrent frontal and sagittal plane range of motion (ROM) kinematics were measured using an MRI-compatible single camera motion capture system. Results: Increased frontal plane ROM was associated with increased brain activity in one cluster extending over the occipital fusiform gyrus and lingual gyrus ( p = .003, z > 3.1). Increased sagittal plane motor control timing error was associated with increased brain activity in multiple clusters extending over the occipital cortex (lingual gyrus), frontal cortex, and anterior cingulate cortex ( p < .001, z > 3.1); see Figure 1 (b). Conclusion: The associations of increased knee frontal plane ROM and sagittal plane timing error with increased activity in regions that integrate visuospatial information may be indicative of an increased propensity for knee injury biomechanics that are, in part, driven by reduced spatial awareness and an inability to adequately control knee abduction motion. Increased activation in these regions during movement tasks may underlie an impaired ability to control movements (i.e., less neural efficiency), leading to compromised knee positions during more complex sports scenarios. Increased activity in regions important for cognition/attention associating with motor control timing error further indicates a neurologically inefficient motor control strategy. [Figure: see text]

scholarly journals 3D kinematic analysis of patients’ gait before and after unilateral total hip replacement

2020 ◽  
Vol 22 (2) ◽  
Author(s):  
Kateřina Kolářová ◽  
Tomáš Vodička ◽  
Michal Bozděch ◽  
Martin Repko
Keyword(s):  
Range Of Motion ◽  
Total Hip Replacement ◽  
Kinematic Analysis ◽  
Hip Replacement ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Step Length ◽  
Total Hip ◽  
Before And After ◽  
Analysis System

Purpose: The purpose of the study was to describe changes in the kinematic parameters in the patients’ gait after total hip replacement. Methods: Research group of men in the end stage of osteoarthritis indicated to the THR (n = 10; age 54.1 ± 7.5 years; weight 92.2 ± 9.6 kg; height 179.7 ± 5.9 cm). All participants underwent a total of three measurements: before surgery, 3 and 6 months after the surgery. Using the 3D kinematic analysis system, the patients’ gait was recorded during each measurement session and kinematic analysis was carried out. The parameters that were monitored included the sagittal range of motion while walking in the ankle, the knee and the hip joints of the operated and the unoperated limb, and the range in the hip joint’s frontal plane, the rotation of pelvis in the frontal and transverse planes, as well as the speed of walking and the walking step length. Results: Significant increases were found in sagittal range of motion in the operated hip joint, sagittal range of motion in the ankle joint on the unoperated side and in the walking step length of the unoperated limb. Conclusions: During walking after a THR, the sagittal range of motion in the ankle of the unoperated limb increases. Also, the range of motion in the sagittal plane on the operated joint increases, which is related to the lengthening of the step of the unoperated lower limb.

The Effect of the TayCo External Ankle Brace on Multidirectional Reach Distance, Balance, and Motion in Collegiate Athletes

2020 ◽  
Vol 25 (6) ◽  
pp. 323-327
Author(s):  
Steven J. Smith ◽  
Cameron J. Powden
Keyword(s):  
Range Of Motion ◽  
Sagittal Plane ◽  
Dynamic Balance ◽  
Plantar Flexion ◽  
Collegiate Athletes ◽  
Frontal Plane ◽  
Plane Motion ◽  
Lower Extremity Function ◽  
Physically Active ◽  
Ankle Brace

Ensuring ankle stability while allowing for functional movement is important when returning patients to physical activity and attempting to prevent injury. The purpose of this study was to examine the effectiveness of the TayCo external and a lace-up ankle brace on lower extremity function, dynamic balance, and motion in 18 physically active participants. Significantly greater range of motion was demonstrated for the TayCo brace compared with the lace-up brace for dorsiflexion and plantar flexion, as well as less range of motion for the TayCo brace compared to the lace-up brace for inversion and eversion. The TayCo brace provided restricted frontal plane motion while allowing increased sagittal plane motion without impacting performance measures.

Clinical, Quantitative Assessment of First Tarsometatarsal Mobility in the Sagittal Plane and Its Relation to Hallux Valgus Deformity

1994 ◽  
Vol 15 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Kaj Klaue ◽  
Sigvard T. Hansen ◽  
Alain C. Masquelet
Keyword(s):  
Hallux Valgus ◽  
Sagittal Plane ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Valgus Deformity ◽  
Main Concern ◽  
First Metatarsophalangeal Joint ◽  
First Metatarsal ◽  
Hallux Valgus Deformity ◽  
First Ray

Today, bunion surgery is still controversial. Considering that a bunion deformity in fact may be a result of multiple causes, the rationale of the currently applied techniques of surgical treatment has not been conclusively demonstrated. In view of the known hypermobility syndrome of the first ray that results in insufficient weightbearing beneath the first metatarsal head, the relationship between this syndrome and hallux valgus deformity has been investigated. The results suggest a direct relationship between painful hallux valgus deformity and hypermobility in extension of the first tarsometatarsal joint. A pathological mechanism of symptomatic hallux valgus is proposed that relates this pathology with primary weightbearing disturbances in the forefoot where angulation of the first metatarsophalangeal joint is one of the consequences. The alignment of the metatarsal heads within the sagittal plane seems to be a main concern in many hallux valgus deformities. As a consequence, treatment includes reestablishing stable sagittal alignment in addition to the horizontal reposition of the metatarsal over the sesamoid complex. As an example, first tarsometatarsal reorientation arthrodesis regulates the elasticity of the multiarticular first ray within the sagittal plane and may be the treatment of choice in many hallux valgus deformities.

Clinical and Radiological Evaluation of Results of Surgical Correction of Forefoot Adduction by Cuneiform and Cuboid Osteotomy Using Radiological Forefoot Measurements

2020 ◽  
Vol 22 (5) ◽  
pp. 263-272
Author(s):  
Barbara Jasiewicz ◽  
Tomasz Potaczek ◽  
Sławomir Duda ◽  
Jakub Adamczyk ◽  
Jacek Lorkowski
Keyword(s):  
First Metatarsal ◽  
Radiologic Evaluation ◽  
Care Givers ◽  
Metatarsal Angle ◽  
Medial Cuneiform ◽  
Age At Surgery ◽  
First Ray ◽  
Metatarsus Adductus ◽  
The Mean

Background. Forefoot adduction is a relatively common problem. It is usually mild or it can be effectively managed conservatively. Severe deformities may require surgical treatment. The aim of the study was to perform a clinical and radiologic evaluation of forefoot adduction correction using medial cuboid and cuneiform osteotomy with a transposed wedge. Material and methods. This is a retrospective study involving 16 patients who underwent 20 procedures. Mean age at surgery was 6 years (3-13). Clinical evaluation was based on measurements of forefoot deviation and patients’/care-givers’ subjective opinion. The radiologic parameters assessed comprised the first ray angle, talar-first metatarsal angle, calcaneal-fifth metatarsal angle, talocalcaneal angle, metatarsus adductus angle, and Kilmartin’s angle. Results were then compared in children below and above 6 years of age. The mean duration of follow-up was 4.6 years (2-9). Results. The clinical and subjective outcome was rated as good in 16 procedures and satisfactory in 4. The talar-first metatarsal angle, calcaneal-fifth metatarsal angle, metatarsus adductus angle, and Kilmartin’s angle were significantly reduced, while the talocalcaneal and first ray angle remained unchanged. A significantly better correction of metatarsus adductus and talar-first metatarsal angle was achieved In children below 6 years of age compared to older patients. Conclusions. 1. Medial cuneiform and cuboid osteotomy with a transposed wedge improves both clinical and radiological parameters, especially in children under the age of 6. 2. Besides the metatarsus adductus angle, the talar-first meta­tarsal, calcaneal-fifth metatarsal and Kilmartin’s angles appear to be good radiologic indicators of correction.

The Effect of Subtalar Arthrodesis Alignment on Ankle Biomechanics

2012 ◽  
Author(s):  
James R. Jastifer ◽  
Peter A. Gustafson ◽  
Robert R. Gorman
Keyword(s):  
Lower Extremity ◽  
Range Of Motion ◽  
Ankle Joint ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Neutral Position ◽  
Moment Arms ◽  
Subtalar Arthrodesis ◽  
Force Moment ◽  
Ankle Biomechanics

Background: The position, axis, and control of each lower extremity joint intimately affects adjacent joint function as well as whole limb performance. There is little describing the biomechanics of subtalar arthrodesis and none describing the effect that subtalar arthrodesis position has on ankle biomechanics. The purpose of the current study is to establish this effect on sagittal plane ankle biomechanics. Methods: A study was performed utilizing a three-dimensional, validated, computational model of the lower extremity. A subtalar arthrodesis was simulated from 20 degrees of varus to 20 degrees of valgus. For each of these subtalar arthrodesis positions, the ankle dorsiflexor and plantarflexor muscles’ fiber force, moment arm, and moments were calculated throughout a physiologic range of motion. Results: Throughout ankle range of motion, plantarflexion and dorsiflexion strength varies with subtalar arthrodesis position. When the ankle joint is in neutral position, plantarflexion strength is maximized in 10 degrees of subtalar valgus and strength varies by a maximum of 2.6% from the peak 221 Nm. In a similar manner, with the ankle joint in neutral position, dorsiflexion strength is maximized with a subtalar joint arthrodesis in 5 degrees of valgus and strength varies by a maximum of 7.5% from the peak 46.8 Nm. The change in strength is due to affected muscle fiber force generating capacities and muscle moment arms. Conclusion: The clinical significance of this study is that subtalar arthrodesis in a position of 5–10 degrees subtalar valgus has biomechanical advantage. This supports previous clinical outcome studies and offers biomechanical rationale for their generally favorable outcomes.

The Custom Total Contact Cast to Offload Foot Ulcers in the Presence of Biomechanical Deformities: A Case Report

2021 ◽  
Vol 67 (3) ◽  
pp. 12-20
Author(s):  
Mohammad Khan ◽  
Anna Stoupine ◽  
Kamal Farha ◽  
Ji Kim ◽  
Poovasit Klinoubol
Keyword(s):  
Sagittal Plane ◽  
Frontal Plane ◽  
Foot Ulcers ◽  
Neutral Position ◽  
Plantar Surface ◽  
Total Contact Cast ◽  
Iatrogenic Complications ◽  
Novel Approach ◽  
Crucial Component

BACKGROUND: Although offloading foot ulcers with a total contact cast (TCC) remains the cornerstone of managing these wounds, the TCC is underutilized. Patient intolerance and potential iatrogenic complications due to TCCs’ general lack of customizability and the inability to address flexible biomechanical deformities that are not in the sagittal plane may be one of the reasons patients with foot ulcers do not receive this crucial component of care. PURPOSE: To describe the use of a novel approach to the standard TCC technique that uses strategic padding to potentially increase patient compliance and comfort while decreasing the likelihood of iatrogenic ulceration, as well as to correct flexible frontal plane biomechanical deformities with casting tape that is pulled medial to lateral, or lateral to medial, to bring the plantar surface of the foot to neutral position. METHODS: The custom total contact cast (C-TCC) was used in a 54-year-old woman who had diabetes, obesity, and a flexible cavovarus foot type with a recurring plantar fifth metatarsal base wound. Weekly debridement followed by silver dressings and C-TCC application were performed. The latter included strategic padding, 2 forms of plaster of paris with contouring, fiberglass, and medial-to-lateral positioning of the foot during application. RESULTS: This case study describes two (2) treatment episodes, with a focus on the second episode. At initial presentation, the ulcer took 5 weeks to heal. During the second treatment, a 48.7% reduction in wound volume was noted after 1 week. By the fourth week of treatment, a 98.7% wound volume reduction was achieved. By the ninth week, the ulcer epithelialized completely. At 1-month and 12-month follow-ups, the site remained fully epithelialized. No iatrogenic ulcerations, cast discomfort, or ambulatory dysfunction were reported by the patient. CONCLUSION: In this case, the C-TCC helped address flexible frontal plane deformities and facilitated healing. Randomized, controlled clinical studies to evaluate the safety and effectiveness of different TCC methods are needed to guide care and improve the utilization of optimal offloading methods for the management of plantar foot ulcers.

scholarly journals The Validity and Reliability of a New Simple Instrument for the Measurement of First Ray Mobility

Sensors ◽  
2020 ◽  
Vol 20 (8) ◽  
pp. 2207
Author(s):  
Pedro V. Munuera-Martínez ◽  
Priscila Távara-Vidalón ◽  
Manuel A. Monge-Vera ◽  
Antonia Sáez-Díaz ◽  
Guillermo Lafuente-Sotillos
Keyword(s):  
Cluster Analysis ◽  
Range Of Motion ◽  
Hallux Valgus ◽  
Measurement Techniques ◽  
Neutral Position ◽  
Validity And Reliability ◽  
New Device ◽  
Total Range ◽  
New Instrument ◽  
First Ray

Several methods have been described to quantify the first ray mobility. They all have certain disadvantages (great size, sophistication, or lack of validation). The objective of this work was to study the validity and reliability of a new instrument for the measurement of first ray mobility. Anterior-posterior radiographs were obtained from 25 normal feet and 24 hallux valgus feet, with the first ray in a neutral position, maximally dorsiflexed and maximally plantarflexed. The first ray mobility was radiographicaly measured in both groups, and was also manually examined with the new device. A cluster analysis determined whether normal and hallux valgus feet were correctly classified, and a graphic analysis of Bland-Altman was performed to compare the radiographic and manual measurement techniques. Based on the radiographs, the first ray mobility only showed significant differences in dorsiflexion between both groups (P = 0.015). First ray dorsiflexion, plantarflexion and total range of motion measured with the new device were different between both groups (P = 0.040, P = 0.011 and P = 0.006, respectively). The silhouette measure of the cohesion and separation coefficients from the cluster analysis was greater than 0.50 for the dorsiflexion, plantarflexion and total range of motion obtained from the radiographs and from the new device. The Bland-Altman graph suggested that 96% of the data presented agreement between both measurement methods. These results suggested that the new instrument was valid and reliable.

Kinematics of the Ankle/Foot Complex—Part 2: Pronation and Supination

Foot & Ankle ◽  
1989 ◽  
Vol 9 (5) ◽  
pp. 248-253 ◽  
Author(s):  
Arne Lundberg ◽  
Ola K. Svensson ◽  
Carin Bylund ◽  
Ian Goldie ◽  
Göran Selvik
Keyword(s):  
External Rotation ◽  
Neutral Position ◽  
X Ray ◽  
First Metatarsal ◽  
Talocalcaneal Joint ◽  
Complex Part ◽  
Metatarsal Bones ◽  
Medial Cuneiform ◽  
Radiopaque Markers ◽  
Made In

The influence of pronation and supination of the foot on the joints of the ankle/foot complex was analyzed three dimensionally by roentgen stereophotogrammetry in eight healthy volunteers. Radiopaque markers were introduced into the tibia, talus, calcaneus, navicular, medial cuneiform, and first metatarsal bones. The subjects stood on a platform that was tilted in 10°-steps from 20° of pronation to 20° of supination. Pairs of x-ray exposures were made in each position. Calculation of resulting joint deviations from the neutral position showed that the largest amounts of motion occurred in the talonavicular joint followed by the talocalcaneal joint, in the latter case mainly in supination. The joints proximal and distal to the medial cuneiform also participated substantially in the total motion registered. The tibia showed an average of 0.2° of external rotation for each degree of supination of the foot.

Iatrogenic metatarsus primus elevatus. Etiology, evaluation, and surgical management

1997 ◽  
Vol 87 (4) ◽  
pp. 165-177 ◽  
Author(s):  
LD Cicchinelli ◽  
CA Camasta ◽  
ED McGlamry
Keyword(s):  
Surgical Treatment ◽  
Bone Graft ◽  
Surgical Management ◽  
Sagittal Plane ◽  
Radiographic Evaluation ◽  
Technical Aspects ◽  
First Metatarsal ◽  
First Ray

Iatrogenic metatarsus primus elevatus is an infrequent but devastating complication of first ray surgery. The authors address their clinical and radiographic evaluation of metatarsus primus elevatus, and describe a surgical treatment with emphasis on the sagittal plane Z-osteotomy. This osteotomy provides predictable and versatile correction for the treatment of iatrogenic deformities of the first metatarsal. It allows for plantarflexion and lengthening of the first metatarsal while avoiding an interpositional bone graft. The technical aspects of the procedure are thoroughly discussed.

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