scholarly journals Arch Height and Maximum Rearfoot Eversion During Jogging in 2 Static Neutral Positions

2012 ◽  
Vol 47 (1) ◽  
pp. 83-90 ◽  
Author(s):  
Sae Yong Lee ◽  
Jay Hertel
Keyword(s):  
Internal Rotation ◽  
Plantar Flexion ◽  
Weight Bearing ◽  
Knee Kinematics ◽  
Frontal Plane ◽  
Neutral Position ◽  
Camera Motion ◽  
Arch Height ◽  
Navicular Drop ◽  
Rearfoot Eversion

Context: Clinically, lowering of the medial longitudinal arch is believed to be closely related to rearfoot eversion. However, the relationship between arch height and rearfoot eversion during gait is unclear. Objectives: (1) To examine the influence of 2 reference positions (weight-bearing neutral position [WBNP] and subtalar neutral position [STNP]) on maximum rearfoot eversion, tibial internal rotation, knee flexion, knee internal rotation, and dorsiflexion-plantar flexion of ankle joint measures during jogging and (2) to compare the relationships among static arch height, navicular drop, and the 2 maximum rearfoot eversion measures. Design: Crossover study. Setting: Gait laboratory. Patients or Other Participants: Thirty-three volunteers between 18 and 40 years of age. Intervention(s): Each participant stood on the treadmill in 2 static positions: WBNP and STNP. Kinematic data were obtained using a 10-camera motion analysis system (120 Hz) when participants jogged at 2.65 m/s on the treadmill in bare feet. Main Outcome Measure(s): Rearfoot and shank angular kinematics, navicular drop, and static arch height. Results: Maximum rearfoot eversion was greater (WBNP: 4.03° ± 2.58°, STNP: 10.91° ± 5.34°) when STNP was the static reference (P < .001). A strong correlation was seen between maximum STNP eversion and navicular drop (r = 0.842) but not between WBNP and navicular drop (r = 0.216). Differences were noted in dorsiflexion and knee kinematics during gait between the static references; however, the effect sizes were low, and the mean differences were smaller than 2°, which was less than 5% of total excursion during gait. Conclusions: Using STNP rather than WBNP as the reference position affects estimates of frontal-plane rearfoot movement but not other ankle or knee motions in jogging.

scholarly journals A feasibility study of a novel, task-specific movement training intervention for women with patellofemoral pain

2017 ◽  
Vol 32 (2) ◽  
pp. 179-190 ◽  
Author(s):  
Gretchen B Salsich ◽  
Barbara Yemm ◽  
Karen Steger-May ◽  
Catherine E Lang ◽  
Linda R Van Dillen
Keyword(s):  
Weight Bearing ◽  
Knee Kinematics ◽  
Frontal Plane ◽  
Patellofemoral Pain ◽  
Patient Specific ◽  
Training Intervention ◽  
Specific Training ◽  
Intervention Effects ◽  
And Function ◽  
Treatment Credibility

Objective: To investigate whether a novel, task-specific training intervention that focused on correcting pain-producing movement patterns was feasible and whether it would improve hip and knee kinematics, pain, and function in women with patellofemoral pain. Design: Prospective, non-randomized, within-group, double baseline, feasibility intervention study. Subjects: A total of 25 women with patellofemoral pain were enrolled. Intervention: The intervention, delivered 2×/week for six weeks, consisted of supervised, high-repetition practice of daily weight-bearing and recreational activities. Activities were selected and progressed based on participants’ interest and ability to maintain optimal alignment without increasing pain. Main measures: Primary feasibility outcomes were recruitment, retention, adherence, and treatment credibility (Credibility/Expectancy Questionnaire). Secondary outcomes assessing intervention effects were hip and knee kinematics, pain (visual analog scale: current, average in past week, maximum in past week), and function (Patient-Specific Functional Scale). Results: A total of 25 participants were recruited and 23 were retained (92% retention). Self-reported average daily adherence was 79% and participants were able to perform their prescribed home program correctly (reduced hip and knee frontal plane angles) by the second intervention visit. On average, treatment credibility was rated 25 (out of 27) and expectancy was rated 22 (out of 27). Hip and knee kinematics, pain, and function improved following the intervention when compared to the control phase. Conclusion: Based on the feasibility outcomes and preliminary intervention effects, this task-specific training intervention warrants further investigation and should be evaluated in a larger, randomized clinical trial.

Modulation of Frontal-Plane Knee Kinematics by Hip-Extensor Strength and Gluteus Maximus Recruitment During a Jump-Landing Task in Healthy Women

2013 ◽  
Vol 22 (3) ◽  
pp. 184-190 ◽  
Author(s):  
John H. Hollman ◽  
Jeffrey M. Hohl ◽  
Jordan L. Kraft ◽  
Jeffrey D. Strauss ◽  
Katie J. Traver
Keyword(s):  
Outcome Measures ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Knee Kinematics ◽  
Frontal Plane ◽  
Gluteus Maximus ◽  
Neuromuscular Control ◽  
Knee Motion ◽  
Jump Landing ◽  
Hip Motion

Context:Abnormal lower extremity kinematics during dynamic activities may be influenced by impaired gluteus maximus function.Objective:To examine whether hip-extensor strength and gluteus maximus recruitment are associated with dynamic frontal-plane knee motion during a jump-landing task.Design:Exploratory study.Setting:Biomechanics laboratory.Participants:40 healthy female volunteers.Main Outcome Measures:Isometric hip-extension strength was measured bilaterally with a handheld dynamometer. Three-dimensional hip and knee kinematics and gluteus maximus electromyography data were collected bilaterally during a jumplanding test. Data were analyzed with hierarchical linear regression and partial correlation coefficients (α = .05).Results:Hip motion in the transverse plane was highly correlated with knee motion in the frontal plane (partial r = .724). After controlling for hip motion, reduced magnitudes of isometric hip-extensor strength (partial r = .470) and peak gluteus maximus recruitment (partial r = .277) were correlated with increased magnitudes of knee valgus during the jump-landing task.Conclusion:Hip-extensor strength and gluteus maximus recruitment, which represents a measure of the muscle’s neuromuscular control, are both associated with frontal-plane knee motions during a dynamic weight-bearing task.

The Effects of a Semi-Rigid Brace or Taping on Talocrural and Subtalar Kinematics in Chronic Ankle Instability

2014 ◽  
Vol 7 (6) ◽  
pp. 471-477 ◽  
Author(s):  
Takumi Kobayashi ◽  
Masayuki Saka ◽  
Eiichi Suzuki ◽  
Naohito Yamazaki ◽  
Makoto Suzukawa ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Ankle Instability ◽  
Plantar Flexion ◽  
Weight Bearing ◽  
Case Series ◽  
Chronic Ankle Instability ◽  
Cross Sectional ◽  
Anterior Translation ◽  
Computed Tomography Images ◽  
Significant Difference

Background. A semi-rigid brace or taping is often used to prevent giving-ways in the joint with chronic ankle instability (CAI). However, it remains unknown whether the application of a semi-rigid brace or taping modifies abnormal kinematics in CAI joints. The objective of this study was to determine if the application of a semi-rigid brace or taping of the ankle normalizes abnormal weight-bearing kinematics in CAI joints during ankle internal rotation in plantar flexion. Methods. A total of 14 male patients with unilateral CAI (mean age 21.1 ± 2.5 years) were enrolled. Three-dimensional bone models created from the computed tomography images were matched to the fluoroscopic images to compute the 6 degrees-of-freedom talocrural, subtalar, and ankle joint complex (AJC) kinematics for the healthy and contralateral CAI joints, as well as for CAI joints with a brace or taping. Selected outcome measures were talocrural anterior translation, talocrural internal rotation, and subtalar internal rotation. Results. There was no significant difference in talocrural anterior translation and internal rotation induced by applying either a semi-rigid brace or taping ( P > .05). For subtalar internal rotation, there was a tendency toward restoration of normal kinematics in CAI joints after applying a semi-rigid brace or taping. However, the difference was not significant ( P > .05). Discussion. Application of a semi-rigid brace or taping had limited effects on the CAI joint during weight-bearing ankle internal rotation in plantar flexion. Further studies using a variety of testing conditions should be conducted in the future. Levels of Evidence: Therapeutic, Level IV: Cross-Sectional Case Series

scholarly journals Leave it or fix it? How fixation of a small posterior malleolar fragment neutralizes rotational forces in trimalleolar fractures

2021 ◽  
Author(s):  
Julia Evers ◽  
Maren Fischer ◽  
Michael Raschke ◽  
Oliver Riesenbeck ◽  
Alexander Milstrey ◽  
...  
Keyword(s):  
Surface Area ◽  
Articular Surface ◽  
Plantar Flexion ◽  
Weight Bearing ◽  
Full Weight Bearing ◽  
Neutral Position ◽  
Screw Osteosynthesis ◽  
Trimalleolar Fractures ◽  
Group I ◽  
Group Ii

Abstract Introduction This study investigated the effects of a small posterior malleolar fragment (PMF), containing less than 25% articular surface area, on ankle joint stability via computed tomography (CT) scanning under full weight bearing in a human cadaveric ankle fracture model. Materials and methods A trimalleolar fracture with a PMF of less than 25% articular surface area was created in 6 pairs of fresh-frozen human cadaveric lower legs. The specimens were randomized into 2 groups stabilized by internal fixation including a positioning screw for syndesmotic reconstruction. In Group I the PMF was addressed by direct screw osteosynthesis, whereas in Group II the fragment was not fixed. Six predefined distances within the ankle were measured under axial loading. CT scans of each specimen were performed in intact and fixated states in neutral position, dorsiflexion and plantar-flexion of the ankle. Results In plantar-flexion, significant differences were detected between the groups with regard to rotational instability. Group II demonstrated a significantly increased inward rotation of the fibula compared with Group I. No significant differences were detected between the groups for each one of the measured distances in any of the three foot positions. Conclusions Additional reduction and fixation of a small PMF seems to neutralize rotational forces in the ankle more effectively than a sole syndesmotic screw. Clinically, this becomes relevant in certain phases of the gait cycle. Direct screw osteosynthesis of a small PMF stabilizes the ankle more effectively than a positioning screw.

Alternative techniques for the clinical assessment of foot pronation

1998 ◽  
Vol 88 (3) ◽  
pp. 119-129 ◽  
Author(s):  
HB Menz
Keyword(s):  
Critical Evaluation ◽  
Reliability And Validity ◽  
Frontal Plane ◽  
Arch Height ◽  
Clinical Measurement ◽  
Navicular Drop ◽  
Foot Posture ◽  
Foot Pronation ◽  
Alternative Techniques ◽  
Foot Morphology

Clinical measurement is a fundamental component of podiatric biomechanics. However, recent research has seriously questioned the reliability and validity of the commonly used approaches to clinical measurement of foot posture. A reevaluation of foot-morphology measurement is therefore warranted. This article discusses alternative clinical techniques of measuring foot type reported in the literature (arch height, footprint indices, the valgus index, and navicular drop) that may prove to be superior to the commonly used podiatric measurement system. On the basis of a critical evaluation of the literature, it would appear that arch height and footprint indices are invalid as means of categorizing foot morphology, while the valgus index and navicular drop offer a number of benefits over traditional frontal-plane measurements. An additional clinical measurement suggested by the author, navicular "drift," is also introduced. The advantages, disadvantages, and clinical application of each of these approaches are discussed in detail.

Association of Navicular Drop and Selected Lower-Limb Biomechanical Measures During the Stance Phase of Running

2014 ◽  
Vol 30 (2) ◽  
pp. 250-254 ◽  
Author(s):  
Mansour Eslami ◽  
Mohsen Damavandi ◽  
Reed Ferber
Keyword(s):  
Internal Rotation ◽  
Stance Phase ◽  
Force Plate ◽  
Knee Adduction Moment ◽  
Tibial Rotation ◽  
Tibial Internal Rotation ◽  
Ankle Inversion ◽  
Navicular Drop ◽  
Peak Knee ◽  
Rearfoot Eversion

There is evidence to suggest that navicular drop measures are associated with specific lower-extremity gait biomechanical parameters. The aim of this study was to examine the relationship between navicular drop and a) rearfoot eversion excursion, b) tibial internal rotation excursion, c) peak ankle inversion moment, and d) peak knee adduction moment during the stance phase of running. Sixteen able-bodied men having an average age of 28.1 (SD = 5.30) years, weight of 81.5 (SD = 10.40) kg, height of 179.1 (SD = 5.42) cm volunteered and ran barefoot at 170 steps/minute over a force plate. Navicular drop measures were negatively correlated with tibial internal rotation excursion (r= −0.53,P= .01) but not with rearfoot eversion excursion (r= −0.19;P= .23). Significant positive correlations were found between navicular drop and peak knee adduction moment (r= .62,P< .01) and peak ankle inversion moment (r= .60,P< .01). These findings suggest that a low navicular drop measure could be associated with increasing tibial rotation excursion while high navicular drop measure could be associated with increased peak ankle and knee joint moments. These findings indicate that measures of navicular drop explained between 28% and 38% of the variability for measures of tibial internal rotation excursion, peak knee adduction moment and peak ankle inversion moments.

scholarly journals Evaluating Foot Kinematics Using Magnetic Resonance Imaging: From Maximum Plantar Flexion, Inversion, and Internal Rotation to Maximum Dorsiflexion, Eversion, and External Rotation

2011 ◽  
Vol 133 (10) ◽  
Author(s):  
Michael J. Fassbind ◽  
Eric S. Rohr ◽  
Yangqiu Hu ◽  
David R. Haynor ◽  
Sorin Siegler ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Internal Rotation ◽  
External Rotation ◽  
Plantar Flexion ◽  
Neutral Position ◽  
Resonance Imaging ◽  
Limit Motion ◽  
Electromagnetic Sensor ◽  
Scan Data

The foot consists of many small bones with complicated joints that guide and limit motion. A variety of invasive and noninvasive means [mechanical, X-ray stereophotogrammetry, electromagnetic sensors, retro-reflective motion analysis, computer tomography (CT), and magnetic resonance imaging (MRI)] have been used to quantify foot bone motion. In the current study we used a foot plate with an electromagnetic sensor to determine an individual subject’s foot end range of motion (ROM) from maximum plantar flexion, internal rotation, and inversion to maximum plantar flexion, inversion, and internal rotation to maximum dorsiflexion, eversion, and external rotation. We then used a custom built MRI-compatible device to hold each subject’s foot during scanning in eight unique positions determined from the end ROM data. The scan data were processed using software that allowed the bones to be segmented with the foot in the neutral position and the bones in the other seven positions to be registered to their base positions with minimal user intervention. Bone to bone motion was quantified using finite helical axes (FHA). FHA for the talocrural, talocalcaneal, and talonavicular joints compared well to published studies, which used a variety of technologies and input motions. This study describes a method for quantifying foot bone motion from maximum plantar flexion, inversion, and internal rotation to maximum dorsiflexion, eversion, and external rotation with relatively little user processing time.

Frontal Plane Ankle Stiffness Increases with Weight-Bearing

2021 ◽  
pp. 110565
Author(s):  
Marie Matos ◽  
Eric J. Perreault ◽  
Daniel Ludvig
Keyword(s):  
Weight Bearing ◽  
Frontal Plane ◽  
Ankle Stiffness

scholarly journals Is postoperative non-weight-bearing necessary? INWN Study protocol for a pragmatic randomised multicentre trial of operatively treated ankle fracture

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ramy Khojaly ◽  
Ruairí Mac Niocaill ◽  
Muhammad Shahab ◽  
Matthew Nagle ◽  
Colm Taylor ◽  
...  
Keyword(s):  
Ankle Fracture ◽  
Multicentre Trial ◽  
Short Form ◽  
Plantar Flexion ◽  
Weight Bearing ◽  
Ankle Fractures ◽  
Hospital Length Of Stay ◽  
Complication Rates ◽  
Fracture Patterns ◽  
Randomised Controlled

Abstract Background Postoperative management regimes vary following open reduction and internal fixation (ORIF) of unstable ankle fractures. There is an evolving understanding that extended periods of immobilisation and weight-bearing limitation may lead to poorer clinical outcomes. Traditional non-weight-bearing cast immobilisation may prevent loss of fixation, and this practice continues in many centres. The purpose of this trial is to investigate the safety and efficacy of immediate weight-bearing (IWB) and range of motion (ROM) exercise regimes following ORIF of unstable ankle fractures with a particular focus on functional outcomes and complication rates. Methods A pragmatic randomised controlled multicentre trial, comparing IWB in a walking boot and ROM within 24 h versus non-weight-bearing (NWB) and immobilisation in a cast for 6 weeks, following ORIF of all types of unstable adult ankle fractures (lateral malleolar, bimalleolar, trimalleolar with or without syndesmotic injury) is proposed. All patients presenting to three trauma units will be included. The exclusion criteria will be skeletal immaturity and tibial plafond fractures. The three institutional review boards have granted ethical approval. The primary outcome measure will be the functional Olerud-Molander Ankle Score (OMAS). Secondary outcomes include wound infection (deep and superficial), displacement of osteosynthesis, the full arc of ankle motion (plantar flexion and dorsal flection), RAND-36 Item Short Form Survey (SF-36) scoring, time to return to work and postoperative hospital length of stay. The trial will be reported in accordance with the CONSORT statement for reporting a pragmatic trial, and this protocol will follow the SPIRIT guidance. Discussion Traditional management of operatively treated ankle fractures includes an extended period of non-weight-bearing. There is emerging evidence that earlier weight-bearing may have equivocal outcomes and favourable patient satisfaction but higher wound-related complications. These studies often preclude more complicated fracture patterns or patient-related factors. To our knowledge, immediate weight-bearing (IWB) following ORIF of all types of unstable ankle fractures has not been investigated in a controlled prospective manner in recent decades. This pragmatic randomised-controlled multicentre trial will investigate immediate weight-bearing following ORIF of all ankle fracture patterns in the usual care condition. It is hoped that these results will contribute to the modern management of ankle fractures. Trial registration ISRCTN Registry ISRCTN76410775. Retrospectively registered on 30 June 2019.

Kinematics of the Ankle/Foot Complex: Plantarflexion and Dorsiflexion

Foot & Ankle ◽  
1989 ◽  
Vol 9 (4) ◽  
pp. 194-200 ◽  
Author(s):  
Arne Lundberg ◽  
Ian Goldie ◽  
Bo Kalin ◽  
Göran Selvik
Keyword(s):  
Plantar Flexion ◽  
Three Dimensional ◽  
Substantial Contribution ◽  
Neutral Position ◽  
Transverse Axis ◽  
Talocrural Joint ◽  
Foot Kinematics ◽  
Talocalcaneal Joint ◽  
Axis Rotation

In an in vivo investigation of eight healthy volunteers, three dimensional ankle/foot kinematics were analyzed by roentgen stereophotogrammetry in 10° steps of motion from 30° of plantar flexion to 30° of dorsiflexion of the foot. The study included all of the joints between the tibia and the first metatarsal, as well as the talocalcaneal joint, and was performed under full body load. Although the talocrural joint was found to account for most of the rotation around the transverse axis occurring from 30° of plantar flexion to 30° of dorsiflexion, there was a substantial contribution from the joints of the arch. This was seen particularly in the input arc from 30° of plantar flexion to the neutral position, where the dorsiflexion motion of these joints amounted to 10% to 41% of the total transverse axis rotation.

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