Effect of 7-Degree Rearfoot Varus and Valgus Wedging on Rearfoot Kinematics and Kinetics During the Stance Phase of Walking

2009 ◽  
Vol 99 (5) ◽  
pp. 415-421 ◽  
Author(s):  
Javier Pascual Huerta ◽  
Juan Manuel Ropa Moreno ◽  
Kevin A. Kirby ◽  
Francisco Javier García Carmona ◽  
Angel Manuel Orejana García
Keyword(s):  
Stance Phase ◽  
Scientific Evidence ◽  
Tibial Rotation ◽  
Foot Orthoses ◽  
Kinematic Effect ◽  
Ankle Inversion ◽  
Foot Progression Angle ◽  
Internal Tibial Rotation ◽  
Significant Change ◽  
The Right

Background: The scientific evidence behind the mechanical function of foot orthoses is still controversial. Research studies that have investigated the kinematic effect of foot orthoses on the lower extremity have shown variable results, with orthoses causing either no significant change or a small significant change in foot kinematics. Methods: The right limbs of 12 healthy asymptomatic individuals were studied in three walking conditions: barefoot, with a 7° rearfoot varus wedge, and with a 7° rearfoot valgus wedge. Kinematic and kinetic variables measured were the foot progression angle, the peak internal tibial rotation angle, and net ankle inversion moments during the stance phase in the three conditions. Results: There were statistically significant differences in the foot progression angle between the barefoot and varus wedge conditions and between the varus and valgus wedge conditions. There were no significant changes in peak internal tibial rotation among the three conditions tested. However, rearfoot varus wedges significantly reduced net ankle inversion moments compared with barefoot and rearfoot valgus wedges. Conclusions: These results support the idea that foot orthoses work by methods other than by changing kinematic parameters. The present study supports the concept that foot orthoses work primarily by altering kinetics, with their effects on kinematics being secondary. (J Am Podiatr Med Assoc 99(5): 415–421, 2009)

scholarly journals IMU-Based Effects Assessment of the Use of Foot Orthoses in the Stance Phase during Running and Asymmetry between Extremities

Sensors ◽  
2021 ◽  
Vol 21 (9) ◽  
pp. 3277
Author(s):  
Juan Luis Florenciano Restoy ◽  
Jordi Solé-Casals ◽  
Xantal Borràs-Boix
Keyword(s):  
Contact Time ◽  
Stance Phase ◽  
Inertial Sensors ◽  
Sagittal Plane ◽  
Plantar Flexion ◽  
Foot Orthoses ◽  
Foot Kinematics ◽  
Running Injuries ◽  
The Right ◽  
Movement Differences

The objectives of this study were to determine the amplitude of movement differences and asymmetries between feet during the stance phase and to evaluate the effects of foot orthoses (FOs) on foot kinematics in the stance phase during running. In total, 40 males were recruited (age: 43.0 ± 13.8 years, weight: 72.0 ± 5.5 kg, height: 175.5 ± 7.0 cm). Participants ran on a running treadmill at 2.5 m/s using their own footwear, with and without the FOs. Two inertial sensors fixed on the instep of each of the participant’s footwear were used. Amplitude of movement along each axis, contact time and number of steps were considered in the analysis. The results indicate that the movement in the sagittal plane is symmetric, but that it is not in the frontal and transverse planes. The right foot displayed more degrees of movement amplitude than the left foot although these differences are only significant in the abduction case. When FOs are used, a decrease in amplitude of movement in the three axes is observed, except for the dorsi-plantar flexion in the left foot and both feet combined. The contact time and the total step time show a significant increase when FOs are used, but the number of steps is not altered, suggesting that FOs do not interfere in running technique. The reduction in the amplitude of movement would indicate that FOs could be used as a preventive tool. The FOs do not influence the asymmetry of the amplitude of movement observed between feet, and this risk factor is maintained. IMU devices are useful tools to detect risk factors related to running injuries. With its use, even more personalized FOs could be manufactured.

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.

The effect of foot orthoses on transverse tibial rotation during walking

2000 ◽  
Vol 90 (1) ◽  
pp. 2-11 ◽  
Author(s):  
TG McPoil ◽  
MW Cornwall
Keyword(s):  
Data Collection ◽  
Video Camera ◽  
Tibial Rotation ◽  
Foot Orthoses ◽  
Rigid Plastic ◽  
Significant Difference ◽  
Internal Tibial Rotation

The purpose of this study was to determine the effectiveness of two types of foot orthoses in controlling the magnitude and rate of internal tibial rotation, measured by the tibial pointer device, during walking. Ten subjects between the ages of 23 and 43 years volunteered to participate in the study. Prior to data collection, each subject was issued two types of foot orthoses: a pair of rigid, plastic orthoses with posting in either the forefoot or the rearfoot, and a pair of soft, accommodative, premolded orthoses with no posting. All subjects wore standardized footwear. Following a controlled break-in period for both footwear and orthoses, each subject was asked to walk at a self-selected speed over a 12-m walkway while the movement of internal tibial rotation was recorded with a video camera during five trials. The results indicated that both the rigid plastic and the accommodative foot orthoses significantly reduced the magnitude and the rate of internal tibial rotation. No significant difference was noted between the soft and rigid foot orthoses conditions.

Adjusting Insert Thickness and Tibial Slope Do Not Correct Internal Tibial Rotation Loss Caused by PCL Resection: In Vitro Study of a Medial Constraint TKA Implanted with Unrestricted Calipered Kinematic Alignment

2021 ◽  
Author(s):  
Alexander J. Nedopil ◽  
Peter J. Thadani ◽  
Thomas H. McCoy ◽  
Stephen M. Howell ◽  
Maury L. Hull
Keyword(s):  
Internal Rotation ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Kinematic Alignment ◽  
Tibial Rotation ◽  
Medial Condyle ◽  
Maximum Extension ◽  
Posterior Tibial ◽  
Internal Tibial Rotation ◽  
Lift Off

AbstractMost medial stabilized (MS) total knee arthroplasty (TKA) implants recommend excision of the posterior cruciate ligament (PCL), which eliminates the ligament's tension effect on the tibia that drives tibial rotation and compromises passive internal tibial rotation in flexion. Whether increasing the insert thickness and reducing the posterior tibial slope corrects the loss of rotation without extension loss and undesirable anterior lift-off of the insert is unknown. In 10 fresh-frozen cadaveric knees, an MS design with a medial ball-in-socket (i.e., spherical joint) and lateral flat insert was implanted with unrestricted calipered kinematic alignment (KA) and PCL retention. Trial inserts with goniometric markings measured the internal–external orientation relative to the femoral component's medial condyle at maximum extension and 90 degrees of flexion. After PCL excision, these measurements were repeated with the same insert, a 1 mm thicker insert, and a 2- and 4-mm shim under the posterior tibial baseplate to reduce the tibial slope. Internal tibial rotation from maximum extension and 90 degrees of flexion was 15 degrees with PCL retention and 7 degrees with PCL excision (p < 0.000). With a 1 mm thicker insert, internal rotation was 8 degrees (p < 0.000), and four TKAs lost extension. With a 2 mm shim, internal rotation was 9 degrees (p = 0.001) and two TKAs lost extension. With a 4 mm shim, internal rotation was 10 degrees (p = 0.002) and five TKAs lost extension and three had anterior lift-off. The methods of inserting a 1 mm thicker insert and reducing the posterior slope did not correct the loss of internal tibial rotation after PCL excision and caused extension loss and anterior lift-off in several knees. PCL retention should be considered when using unrestricted calipered KA and implanting a medial ball-in-socket and lateral flat insert TKA design, so the progression of internal tibial rotation and coupled reduction in Q-angle throughout flexion matches the native knee, optimizing the retinacular ligaments' tension and patellofemoral tracking.

scholarly journals Posterior Tibial Subchondral Bone and Meniscal Slope Correlate with In Vivo Internal Tibial Rotation

2017 ◽  
Vol 5 (7_suppl6) ◽  
pp. 2325967117S0030
Author(s):  
Elmar Herbst ◽  
Tom Gale ◽  
Kanto Nagai ◽  
Yasutaka Tashiro ◽  
James J. Irrgang ◽  
...  
Keyword(s):  
Subchondral Bone ◽  
Tibial Rotation ◽  
Posterior Tibial ◽  
Internal Tibial Rotation

WITHDRAWAL OF A SHAREHOLDER IN THE CASE OF A REORGANISATION: EVALUATION OF EFFECTIVENESS AS A REMEDY

2021 ◽  
Vol 20 (6) ◽  
pp. 168-190
Author(s):  
A.A. KUZNETSOV
Keyword(s):  
Economic Uncertainty ◽  
Shareholder Protection ◽  
Significant Change ◽  
The Right ◽  
Right Of Withdrawal ◽  
A Company

The article discusses the right to withdraw from a company as a method of shareholder protection in the event of reorganisation. In particular, the disadvantages of this method of protection are analysed and it is concluded that it generates significant costs and legal and economic uncertainty. It is therefore proposed that the right of withdrawal in the event of reorganisation should be abandoned unless such reorganisation results in a significant change in the company.

scholarly journals The difference between the medial and lateral posterior tibial slope is associated with greater internal tibial rotation

2018 ◽  
Vol 6 (4_suppl2) ◽  
pp. 2325967118S0003
Author(s):  
Elmar Herbst ◽  
Andreas Imhoff ◽  
James Irrgang ◽  
William Anderst ◽  
Freddie Fu
Keyword(s):  
Acl Reconstruction ◽  
Tibial Slope ◽  
Tibial Rotation ◽  
Tibial Shaft ◽  
Posterior Tibial ◽  
Downhill Running ◽  
Lateral Posterior ◽  
Internal Tibial Rotation ◽  
The Difference

The objective of this study was to investigate the effect of lateral and medial posterior tibial slope (PTS) and meniscal slope (PMS) on in-vivo anterior tibial translation (ATT) and internal tibial rotation (IR) during downhill running on the healthy contralateral knee twenty-four months after ACL reconstruction. Forty-two individuals (twenty-six males; mean age 21.2 ± 6.9 years) who underwent unilateral ACL reconstruction were included in this study. Morphologic parameters were measured on 3 T magnetic resonance images (MRI) using the 3D DESS sequence on the ACL reconstructed and healthy contralateral knee. Lateral and medial PTS and PMS were measured according to the method described by Hudek et al. Briefly, the tibial shaft axis was determined by connecting the centroids of two circles fitting the tibial shaft on the central sagittal MRI slice. The PTS and PMS were determined by the angle between the tibial shaft axis and the line connecting the two most proximal anterior and posterior subchondral bone and meniscal points in the center of each joint compartment. Three-dimensional in-vivo kinematics data were acquired using dynamic stereo x-ray during downhill running (3.0 m/s, 10° slope) at 150 Hz twenty-four months after unilateral ACL reconstruction. A multiple regression analysis was performed (p < .05). The lateral and medial PTS and PMS as well as the differences between the medial and lateral compartment slopes were not significantly related to ATT in the healthy contralateral knees twenty-four months after ACL reconstruction (p > .05). The lateral and medial PTS and PMS were not significantly related to peak internal tibial rotation (p > .05). However, the difference between the medial and lateral PTS as well as PMS was associated with greater internal tibial rotation (PTS: b=1.55, p < .001; PMS: b = .71, p = .02). The most important finding of the present study is that the difference between the medial and lateral posterior tibial and meniscal slope are related to in-vivo internal tibial rotation during downhill running. ATT was not significantly influenced by the tibial bony and meniscal morphology. Taking into account the results of the present study, the difference between the medial and the lateral PTS and PMS may contribute to IR when an ACL injury occurs. However, the analyzed movement was a straight-ahead run without any cutting or pivoting maneuvers commonly related to ACL tears. In such motion patterns, the correlations may be even stronger compared to the results of this study.

Regional coronary vasoconstriction in response to stimulation of stellate ganglia

1982 ◽  
Vol 243 (3) ◽  
pp. H410-H415 ◽  
Author(s):  
L. E. Rinkema ◽  
J. X. Thomas ◽  
W. C. Randall
Keyword(s):  
Left Ventricle ◽  
Regional Variations ◽  
Coronary Vasoconstriction ◽  
Blocking Agents ◽  
Anesthetized Dogs ◽  
Significant Change ◽  
The Right ◽  
Adrenergic Blocking ◽  
Beta Adrenergic Blocking Agents ◽  
Adrenergic Blocking Agents

Recent experiments have demonstrated that direct and reflex sympathetic stimulation elicit coronary vasoconstriction when the inotropic and chronotropic effects are blocked with beta-adrenergic blocking agents. This vasoconstriction can be blocked with alpha-adrenergic blocking agents. Regional variations in the flow reduction produced by right (RSS) vs. left (LSS) stellate stimulation were delineated in this study. Open-chest pentobarbital-anesthetized dogs were given propranolol (1 mg/kg iv). Hearts were neurally decentralized and paced just above the spontaneous heart rate. Radiolabeled microspheres (15 +/- 2 micrometers) were injected into the left atrium before and during RSS (n = 11) or LSS (n = 11). RSS produced relatively little vasoconstriction confined to anterior left ventricle. In contrast, LSS produced significant vasoconstriction in all areas of the right and left ventricles. In the endocardial half of the left ventricle the flow decrease was uniformly distributed among the regions studied. In the epicardial half of the flow decrease was more pronounced in posterior than in anterior regions. No significant change occurred in the endo-epi ratios with RSS, but with LSS there was a significant change in three areas. The changes were related to regional variations in the degree of epicardial constriction. Thus RSS and LSS have differential effects (quantitatively) on regional coronary blood flow.

Effect of floor reaction ankle–foot orthosis on crouch gait in patients with cerebral palsy: What can be expected?

2017 ◽  
Vol 42 (3) ◽  
pp. 245-253 ◽  
Author(s):  
Harald Böhm ◽  
Hösl Matthias ◽  
Frank Braatz ◽  
Leonhard Döderlein
Keyword(s):  
Cerebral Palsy ◽  
Standard Deviation ◽  
Knee Extension ◽  
Spastic Cerebral Palsy ◽  
Foot Orthoses ◽  
Cross Sectional ◽  
Positive Effects ◽  
Foot Progression Angle ◽  
Ankle Foot Orthoses ◽  
Crouch Gait

Background: Floor reaction ankle–foot orthoses are commonly prescribed to improve knee extension of children with cerebral palsy having crouch gait. Their effectiveness is debated. Therefore, the objective of this study is to optimize current prescription criteria for the improvement of crouch gait. Study design: Cross-sectional interventional study. Methods: A total of 22 patients with bilateral spastic cerebral palsy, between 6 and 17 years, Gross Motor Function Classification System II–IV participated in this study. Instrumented gait analysis was done under three conditions: barefoot, shoed, and with orthotics. Patients were divided into two groups: good and non-responders with more and less than 8.8° improvement of knee extension during walking, respectively. A multiple predictor analysis was done on parameters that were different between groups. Results: In total, 12 of 22 patients showed good response in knee extension with a mean change of 17° (standard deviation = 5°). Good responders showed a significantly smaller walking velocity, knee extension strength, ankle plantarflexion strength, and greater external foot progression angle compared to non-responders. Foot progression angle together with ankle plantarflexion strength explained 37% of the variance in improvement of knee extension. Conclusion: With appropriate patient selection, an improvement of crouch gait by ankle–foot orthoses of 17° (standard deviation = 5°) can be expected. Patients with slow velocity, weak plantarflexors, and external foot progression benefit most. Joint contractures were no contraindications. Clinical relevance This study showed that gait in patients with low functional level benefit most from ankle–foot orthoses. Unlike in patients with higher functional status, contractures of hip, knee, and ankle did not reduce the positive effects on gait. The suggested prescription criteria may help to better select appropriate patients for orthotics.

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