Short-term results of gait analysis with the Heidelberg foot measurement method and functional outcome after operative treatment of ankle fractures

Background Ankle fractures are common fractures in trauma surgery. Several studies have compared gait patterns between affected patients and control groups. However, no one used the Heidelberg Foot Measurement Method in combination with statistical parametric mapping of the entire gait cycle in this patient cohort. We sought to identify possible mobility deficits in the tibio-talar joint and medial arch in patients after ankle fractures as a sign of stiffness and pain that could result in a pathological gait pattern. We focused on the tibio-talar flexion as it is the main movement in the tibio-talar joint. Moreover, we examined the healing progress over time. Methods Fourteen patients with isolated ankle fractures were included prospectively. A gait analysis using the Heidelberg Foot Measurement Method was performed 9 and 26 weeks after surgery to analyse the tibio-talar dorsal flexion, the foot tibia dorsal flexion, the subtalar inversion and the medial arch as well as the cadence, the walking speed and the ground reaction force. The American Orthopedic Foot & Ankle Society ankle hindfoot score was used to obtain clinical data. Results were compared to those from 20 healthy participants. Furthermore, correlations between the American Orthopedic Foot & Ankle Society hindfoot score and the results of the gait analysis were evaluated. Results Statistical parametric mapping showed significant differences for the Foot Tibia Dorsal Flexion for patients after 9 weeks (53–75%: p = 0.001) and patients after 26 weeks (58–70%: p = 0.011) compared to healthy participants, respectively. Furthermore, significant differences regarding the tibio-talar dorsal flexion for patients 9 weeks after surgery (15–40%: p < 0.001; 56,5–70%: p = 0.007; 82–88%: p = 0.033; 97–98,5%: p = 0.048) as well as patients after 26 weeks (62,5–65%: p = 0.049) compared to healthy participants, respectively. There were no significant differences looking at the medial arch and the subtalar inversion. Moreover, significant differences regarding the ground reaction force were found for patients after 9 weeks (0–17%: p < 0.001; 21–37%: p < 0.001; 41–54%: p < 0.001; 60–64%: p = 0.013) as well as patients after 26 weeks (0–1,5%: p = 0.046; 5–15%: p < 0.001; 27–33%: p = 0.001; 45–49%: p = 0.005; 57–59%: p = 0.049) compared to healthy participants, respectively. In total, the range of motion in the tibio-talar joint and the medial arch was reduced in affected patients compared to healthy participants. Patients showed significant increase of the range of motion between 9 and 26 weeks. Conclusions This study shows, that patients affected by ankle fractures show limited mobility in the tibio-talar joint and the medial arch when compared to healthy participants. Even though the limitation of motion remains at least over a period of 26 weeks, a significant increase can be recognized over time. Furthermore, if we look at the absolute values, the patients’ values tend to get closer to those of the control group. Trial registration This study is registered at the German Clinical Trials Register (DRKS00023379).

Accelerometer-based prediction of ground reaction force in head-out water exercise with different exercise intensity countermovement jump

Background Water jumping exercise is an alternative method to achieve maintenance of bone health and reduce exercise injuries. Clarifying the ground reaction force (GRF) of moderate and high cardiopulmonary exercise intensities for jumping movements can help quantify the impact force during different exercise intensities. Accelerometers have been explored for measuring skeletal mechanical loading by estimating the GRFs. Predictive regression equations for GRF using ACC on land have already been developed and performed outside laboratory settings, whereas a predictive regression equation for GRF in water exercises is not yet established. The purpose of this study was to determine the best accelerometer wear-position for three exercise intensities and develop and validate the ground reaction force (GRF) prediction equation. Methods Twelve healthy women (23.6 ± 1.83 years, 158.2 ± 5.33 cm, 53.1 ± 7.50 kg) were recruited as participants. Triaxial accelerometers were affixed 3 cm above the medial malleolus of the tibia, fifth lumbar vertebra, and seventh cervical vertebra (C7). The countermovement jump (CMJ) cadence started at 80 beats/min and increased by 5 beats per 20 s to reach 50%, 65%, and 80% heart rate reserves, and then participants jumped five more times. One-way repeated analysis of variance was used to determine acceleration differences among wear-positions and exercise intensities. Pearson’s correlation was used to determine the correlation between the acceleration and GRF per body weight on land (GRFVLBW). Backward regression analysis was used to generate GRFVLBW prediction equations from full models with C7 acceleration (C7 ACC), age, percentage of water deep divided by body height (PWDH), and bodyweight as predictors. Paired t-test was used to determine GRFVLBW differences between values from the prediction equation and force plate measurement during validation. Lin’s CCC and Bland–Altman plots were used to determine the agreement between the predicted and force plate-measured GRFVLBW. Results The raw full profile data for the resultant acceleration showed that the acceleration curve of C7 was similar to that of GRFv. The predicted formula was − 1.712 + 0.658 * C7ACC + 0.016 * PWDH + 0.008 * age + 0.003*weight. Lin’s CCC score was 0.7453, with bias of 0.369%. Conclusion The resultant acceleration measured at C7 was identified as the valid estimated GRFVLBW during CMJ in water.

INSOLE-BASED ESTIMATION OF COMPLETE GROUND REACTION FORCE WITH GAUSSIAN KERNEL REGRESSION AND DATA EXPANSION

A method for estimating ground reaction force (GRF) with plantar pressure was proposed in this paper. The estimation model was constructed to approximate the nonlinear relationships between GRF and the plantar pressure according to the linear combinations of Gaussian kernel functions. Partial least squares regression (PLSR) was adopted to obtain model parameters and eliminate multicollinearity among the pressure components. The general model and subject-specific models were constructed for 12 male and 4 female subjects. Moreover, a data expansion method was introduced for the establishment of subject-specific model, which is implemented by searching and adopting the data with consistent statistical characteristics in a pre-established database. That approach is particularly meaningful for the group whose walking ability is limited or clinic where the force platform is not available. The NRMSEs (%) for general model were 5.27–7.85% (GRF_V), 7.35–8.53% (GRF_ML), and 8.82–10.54% (GRF_AP). The maximum NRMSEs (%) for subject-specific models were 5.02% (GRF_V), 9.91% (GRF_ML), and 10.23% (GRF_AP). Results showed that both general and subject-specific models achieved higher accuracy than existing methods such as linear regression and neural network methods.

Use of a protective cover affects ground reaction force measurements obtained from dogs walking on a validated pressure-sensitive walkway

OBJECTIVE To determine whether use of a protective cover would affect temporospatial gait or ground reaction force (GRF) measurements obtained from dogs walking on a validated pressure-sensitive walkway (PSW). ANIMALS 5 healthy dogs. PROCEDURES In a crossover study design, all dogs were walked across a calibrated PSW with and without a protective cover in place in random order. Temporospatial gait data and GRFs obtained with and without the cover in place were compared. RESULTS No significant differences were identified in temporospatial gait measurements obtained with versus without the cover in place. The bias was low for all variables, and the 95% limits of agreement included 0. In contrast, significant differences were found between measurements obtained with versus without the cover in place for most GRFs, with measurements obtained with the cover in place significantly lower than those obtained without a cover. CLINICAL RELEVANCE Results suggested that for dogs walking over a PSW, GRFs, but not temporospatial gait variables, would be significantly lower if a protective cover was placed over the walkway, compared with values obtained without a cover in place.

Protection by Ankle Brace for Lower-Extremity Joints in Half-Squat Parachuting Landing With a Backpack

Half-squat parachuting landing is a kind of activity with high impact force. Injuries on lower-extremity joints are common in half-squat parachuting landing and would be increased with a backpack. An ankle brace was used to prevent ankle injuries in landing. However, few quantitative studies reported about the protection of an ankle brace for lower-extremity joints in half-squat parachuting landing with a backpack. This study focused on evaluating the protective effects of an ankle brace in half-squat parachuting landing with a backpack. Seven male participants landed from 120 cm with a backpack and an ankle brace. Each participant performed three landing trials on every experimental condition. Kinetics and kinematics of the hip, knee, and ankle were analyzed. It was found that the ankle brace did not significantly affect the ground reaction force with backpack but increased the ground reaction force from 14.7 ± 2.0 bodyweight to 16.2 ± 1.9 bodyweight (p = 0.017) without the backpack. The ankle brace significantly (p &lt; 0.05) decreased the angular displacement, angular velocity, and angular acceleration of the ankle both without and with the backpack. In conclusion, the ankle brace could restrict ankle motion and significantly increase ground reaction force without the backpack. However, the ankle brace did not significantly influence ground reaction force and still restricted ankle motion with the backpack. Therefore, the ankle brace was more effective in half-squat parachuting landing with the backpack than no-backpack landing.

A model-based strategy for quadruped running with differentiated fore- and hind leg morphologies

This article introduces a model-based strategy for a quadruped robot with differentiated fore- and hind-leg ground reaction-force patterns to generate animal-like running behavior. The proposed model comprises a rigid body and two eSLIP legs with dampers. The eccentric-SLIP (eSLIP) model extends the traditional spring-loaded inverted pendulum (SLIP) model by adding a bar to offset the spring direction. The proposed two-leg eSLIP (TL-eSLIP) model’s fore- and hind legs were designed to have the same offset magnitude but in opposite offset directions, producing different braking and thrusting force patterns. The TL-eSLIP model’s reference leg trajectories were designed based on the fixed-point motion of the eSLIP model. Additionally, the legs were clock torque-controlled to modulate leg motion and stabilize the model to follow its natural dynamics. The model’s equations for motion were derived, and the model’s dynamic behavior was simulated and analyzed. The simulation results indicate that the model with leg offsets and in either trotting or pronking has differentiated leg force patterns, and it is more stable and has larger basins of attraction than the model without leg offsets. A quadruped robot was built for experimental validation. The experimental results demonstrate that the robot with differentiated legs ran with differentiated ground reaction force patterns and ran more stably than another robot with the same leg morphology.

Effectiveness of Insole Colour on Impact Loading and Lower-Limb Kinematics When Running at Preferred and Nonpreferred Speeds

While colour of red can play a significant role in altering human perception and performances, little is known about its perceptual-motor effect on running mechanics. This study examined the effects of variations in insole colours on impact forces, ankle kinematics, and trial-to-trial reliability at various running speeds. Sixteen male recreational runners ran on instrumented treadmill at slow (90%), preferred (100%), and fast (110%) running speeds when wearing insoles in red, blue, and white colours. We used synchronized force platform and motion capturing system to measure ground reaction force, ankle sagittal and frontal kinematics, and movement variability. A two-way (colour x speed) ANOVA with repeated measures was performed with Bonferroni adjusted post hoc comparisons, with alpha set at 0.05. Data analyses indicated that participants demonstrated higher impact and maximum loading rate of ground reaction force, longer stride length, shorter contact time, and smaller touchdown ankle inversion as well as larger ankle sagittal range of motion (RoM), but smaller frontal RoM in fast speed as compared with preferred P < 0.05 and slow speeds P < 0.001 . Although insole colour had minimal effect on mean values of any tested variables P > 0.05 , participants wearing red-coloured orthoses showed higher coefficient of variation values for maximum loading rate than wearing blue insoles P = 0.009 . These results suggest that running at faster speed would lead to higher impact loading and altered lower-limb mechanics and that colour used on the tops of insoles influences the wearers’ movement repeatability, with implications for use of foot insole in running.

Variable Heights Influence Lower Extremity Biomechanics and Reactive Strength Index during Drop Jump: An Experimental Study of Male High Jumpers

Introduction. This study finds the lower limbs’ reactive strength index and biomechanical parameters on variable heights. Objective. This research aims to reveal the effects of drop height on lower limbs’ reactive strength index and biomechanical parameters. Methods. Two AMTI force platforms and Vicon motion capture system were used to collect kinematic and dynamic signals of the lower limbs. Results. The drop height had significant effects on peak vertical ground reaction force and peak vertical ground reaction force in the extension phase, lower limbs’ support moment, eccentric power of the hip joint, eccentric power of the knee joint, eccentric power of the ankle joint, and concentric power of the hip joint. The drop height had no significant effects on the reactive strength index. Reactive strength index (RSI) had no significant correlations with the personal best of high jumpers. The optimal loading height for the maximum reactive strength index was 0.45 m. Conclusion. The optimal loading height for the reactive strength index can be used for explosive power training and lower extremity injury prevention.

Effect of osteopathic manipulation on gait asymmetry

Context Movement and loading asymmetry are associated with an increased risk of musculoskeletal injury, disease progression, and suboptimal recovery. Osteopathic structural screening can be utilized to determine areas of somatic dysfunction that could contribute to movement and loading asymmetry. Osteopathic manipulation treatments (OMTs) targeting identified somatic dysfunctions can correct structural asymmetries and malalignment, restoring the ability for proper compensation of stresses throughout the body. Little is currently known about the ability for OMTs to reduce gait asymmetries, thereby reducing the risk of injury, accelerated disease progression, and suboptimal recovery. Objectives To demonstrate whether osteopathic screening and treatment could alter movement and loading asymmetry during treadmill walking. Methods Forty-two healthy adults (20 males, 22 females) between the ages of 18 and 35 were recruited for this prospective intervention. Standardized osteopathic screening exams were completed by a single physician for each participant, and osteopathic manipulation was performed targeting somatic dysfunctions identified in the screening exam. Three-dimensional (3-D) biomechanical assessments, including the collection of motion capture and force plate data, were performed prior to and following osteopathic manipulation to quantify gait mechanics. Motion capture and loading data were processed utilizing Qualisys Track Manager and Visual 3D software, respectively. Asymmetry in the following temporal, kinetic, and kinematic measures was quantified utilizing a limb symmetry index (LSI): peak vertical ground reaction force, the impulse of the vertical ground reaction force, peak knee flexion angle, step length, stride length, and stance time. A 2-way repeated-measures analysis of variance model was utilized to evaluate the effects of time (pre/post manipulation) and sex (male/female) on each measure of gait asymmetry. Results Gait asymmetry in the peak vertical ground reaction force (−0.6%, p=0.025) and the impulse of the vertical ground reaction force (−0.3%, p=0.026) was reduced in males following osteopathic manipulation. There was no difference in gait asymmetry between time points in females. Osteopathic manipulation did not impact asymmetry in peak knee flexion angle, step length, stride length, or stance time. Among the participants, 59.5% (25) followed the common compensatory pattern, whereas 40.5% (17) followed the uncommon compensatory pattern. One third (33.3%, 14) of the participants showed decompensation at the occipitoatlantal (OA) junction, whereas 26.2% (11), one third (33.3%, 14), and 26.2% (11) showed decompensation at the cervicothoracic (CT), thoracolumbar (TL), and lumbosacral (LS) junctions, respectively. Somatic dysfunction at the sacrum, L5, right innominate, and left innominate occurred in 88.1% (37), 69.0% (29), 97.6% (41), and 97.6% (41) of the participants, respectively. Conclusions Correcting somatic dysfunction can influence gait asymmetry in males; the sex-specificity of the observed effects of osteopathic manipulation on gait asymmetry is worthy of further investigation. Osteopathic structural examinations and treatment of somatic dysfunctions may improve gait symmetry even in asymptomatic individuals. These findings encourage larger-scale investigations on the use of OMT to optimize gait, prevent injury and the progression of disease, and aid in recovery after surgery.